Fill and Sign the Alaska Notice Form

STOP LENDING NOTICE--INDIVIDUAL (A.S. § 34.35.062) COMES NOW, ___________________________________ , a claimant to whom payment for labor, material, service, or equipment furnished for a project is past due, and would provide notice of the following: 1. Pursuant to Alaska Statute § 34.35.062, the following lender, __________________________________ , is hereby notified to stop disbursing, advancing, or otherwise providing construction financing for the improvement of the property located at: ___________________________________ . 2. The undersigned claimant, __________________________________ , may be reached at the following address and telephone number: ____________________________________ . 3. The undersigned claimant furnished the following labor, material, services, or equipment to the above-mentioned project: _____________________________________ . 4. Said labor, material, services, or equipment was furnished to ________________________________________ . 5. The owner of the property undergoing improvement in believed to be ______________________________________ . 6. The amount due and unpaid to the claimant for the labor, material, services, or equipment provided is $ ________________ . _________________________ Signature _______ ___________________ Print or Type Name Stop Lending Notice Page 1 of 2 Verification I __________________________________ say on oath or affirm that I have read the foregoing (or attached) document and believe all statements made in the document are true. ______________________ Signature State of Judicial District (or County of or Municipality of ______________ The foregoing instrument was acknowledged before me this (date) by (name of person who acknowledged). Signature of Person Taking Acknowledgment Title or Rank My Commission Expires: __________ 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 Stop Lending Notice Page 2 of 2