Proof of Service Notice
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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)
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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.
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Signature of Claimant
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