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Fill and Sign the 50 State Lien Law Handbook Sivyer Barlow Ampamp Watson Pa Form

Fill and Sign the 50 State Lien Law Handbook Sivyer Barlow Ampamp Watson Pa Form

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RESPONSE TO DEMAND FOR ACCOUNT BY OWNER – INDIVIDUAL (W.Va. Code §38-2-19) COMES NOW, __________________________________, as a subcontractor, laborer, mechanic, workman or party furnishing labor and/or materials for the improvement of the located at and described as _______________________________________________________________________________________________________________________________________________, and pursuant to W.Va. Code §38-2-19 the undersigned hereby provides to the owner of the above-described property the following itemized account: 1. The following work was done or caused to be done, or the following materials or other equipment was furnished for such work: _______________________________________________________________________________________________________________________________________________________________________________________________________________________. 2. The dates upon which said work was done or materials furnished are as follows : _______________________________________________________________________________________________________________________________________________________________________________________________________________________. 3. The price charged is $ ________________. 4. The nature of said work or materials is as follows: _______________________________________________________________________________________________________________________________________________________________________________________________________________________. This the _____ day of _______________, 20______. _________________________ Signature_________________________ Type or Print Name Certificate of Delivery I, ____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to _____________________________________ by: ( ) Personal Service ( ) Mailing a true and correct copy of same by certified or registered U.S. mail, postage prepaid, return receipt requested. So certified this the _____ day of _________________, 20______.________________________ Signature

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