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Proof of Service

Free Sample Proof of Service Notice

When filing a Claim of Lien some States Require a Proof of Service Notice of Furnishing.

Proof of Service Notice

I, ______________ do hereby declare that I have served copies of the above Claim of Lien Notice:

[ ] By personally delivering copies to (the name and title of person served the Claim of Lien notice)


at the following address:


on ____/____/______
at ____:______ AM / PM.

[ ] By First Class Certified or Registered Mail Service with postage prepaid and addressed to

each of the above listed parties at their address shown above on ____/____/______.

I declare under the penalty of perjury that the foregoing is true and correct.

Signature of Claimant



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