Fill and Sign the Accounting of Amount Due and Unpaid Individual Alaska Form

ACCOUNTING OF AMOUNT DUE AND UNPAID--INDIVIDUAL (A.S. § 34.35.064(b)) COMES NOW, __________________________________ , as a party which has provided labor, materials, services, or equipment for the improvement of the property located at __________________________________ , and is entitled to a lien thereby, and would state as follows: 1. On or about the _____ day of ______________ , 20 ______ , the undersigned lien claimant received a request from parties with an interest in the above described property for information regarding the status of said lien, and has responded to same within five (5) business days. 2. The following is the most recent accounting of the amount due to the undersigned under the terms of the contract: __________________________________ . 3. The following is a description of labor, materials, services, or equipment, that the undersigned claimant reasonably anticipates furnishing: ____________________________________ . This the ____ day of _____________ , 20 _______ . _________________________ Signature ______ ____________________ Print or Type 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 with signed receipt ( ) Mailing a true and correct copy of same by first-class U.S. mail, postage prepaid, return signed receipt requested to ___________________________, So certified this the ______ day of ___________________, 20____. ________________________ Signature AK § 34.35.064 Accounting of Amount Due and Unpaid Page 1 of 1