Fill and Sign the Claim of Lien Corporation Form

Claim of Lien Page 1 of 2 Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only--------------------- Name: ____________________ Company: __________________ Address: ____________________ City: ___________________ State: ______ Zip: _________ Phone: _________________ Fax: ___________________ CLAIM OF LIEN-CORPORATION (M.S.A.§ 570.1111) NOTICE IS HEREBY GIVEN that on the _____ day of _______________, 20______, _____________________________, a ____________________________ corporation whose address is _______________________________________________________________________, first provided labor or material for an improvement to: [Legal Description of Property from Notice of Commencement, including property tax identification number and address] _______________________________________________________________________________________________________________________________________________, the (Owner) (Lessee) of which property is __________________________________, whose address is ___________________________________. The last day of providing the labor or material was the _____ day of _______________, 20_____. CONTRACTORS, SUBCONTRACTORS, OR SUPPLIERS : The lien claimant's contract amount, including extras, is $_____________. The lien claimant has received payment thereon in the total amount of $___________, and therefore claims a construction lien upon the above-described real property in the amount of $_____________. LABORERS : The lien claimant's hourly rate, including fringe benefits and withholdings, is $_____________. There is due and owing to or on behalf of the laborer the sum of $_____________ for which the laborer claims a construction lien upon the above-described real property. This the _____ day of ______________, 20______.
page 2 of 2 claims to work performed by certain other parties : the lien claimant has received payment under the terms of a written contract or in a lump sum, on the date, The last day of providing labor or material was the day of, 20. Claimants : the last day of providing labor or material on the above-described real property was on the day of , 20. Page 3 of 2 claims of lennius claim: the owner(s) of real property, on account of injury of persons, property, or the public health, safety, or welfare of the people of the county, of the state or the country, are: (1) entitled to notice from the lien claimant that he or she is entitled to recover his or her property from the lien claimant: (a) within three months from the date that notice is given to the owner(s) of the real property; or (b) during the pendency of proceedings by way of judicial process. (2) the owner(s) are entitled to a hearing before a county court with jurisdiction over construction liens upon the date specified in subclause (1) (a), within three months from the date of giving notice. (3) the owner(s) are required to pay to the lien claimant the amount of the work for which he or she is found on the land, not to exceed two days' labor or material, during the three months preceding the date of the hearing before the court. (4) the lien claimant must pay to the owner the full amount of his or her judgment against him or her. (5) the lien claimant is not entitled to recover the wages or profits of the owner of real property under a subcontract, subcontractor contract, or work purchase agreement made during the six months preceding the filing of a claim for a lien against real property. (6) the lien claimant is not authorized by the owner(s) of real property to enter upon the land or any part of it to perform repair or removal work for the lien claimant. (7) the owner(s) of real property are entitled to a review of the determination made by the county court and their lien claim may be dismissed by the court. Claims of lender(s) claim: lien claimant provides a notice of claim to the holder of a lien on the above-