Fill and Sign the Alabama Verified Statement of Mechanics Lien Formsdeeds

STATE OF ALABAMACOUNTY OF ______________ MATERIALMAN’S LIEN VERIFIED STATEMENT ____________________________, files this statement in writing, verified by the oath of _____________________, who has personal knowledge of the facts herein set forth: That said _____________________, claims a lien upon the following property, situated in ________________ County, Alabama, to-wit:Property described in Exhibit A, which is attached hereto and incorporated herein by reference. This lien is claimed, separately and severally, as to both the buildings and improvements thereon, and the said land.That said lien is claimed to secure an indebtedness of $__________________, with interest, from _________________, for materials which were provided to the contractor, _____________________.The name of the owner or proprietor of the said property is _______________________________. ____________________________________ Before me, the undersigned Notary Public, in and for ______ County State of Alabama, personally appeared _____________________, who being duly sworn, does depose and say: that he/she/they has personal knowledge of the facts set forth in the foregoing statement of lien, and that the same are true and correct to the best of his/her/their knowledge and belief. _____________________________________ Subscribed and sworn to before me on this day of _________ _________. ______________________________________Notary Public This Instrument was Prepared By:____________________________________________________________________________________Telephone: ____________