Fill and Sign the Claimants Statement Lfg Form

Notice of Furnishing Page 1 of 2 NOTICE OF FURNISHING – INDIVIDUAL ( N.H. Rev. Stat. Ann. § 447:6) [Name of Claimant] [Address of Claimant] To: [Name of Owner or Person in Charge of property] [Address of Owner or Person in Charge of property] To: [Name of Contractor] [Address of Contractor]COMES NOW, ____________________________, as a party which has provided labor and/or materials for the improvement of the property located at and described as ____________________________________, and would state as follows: 1.The undersigned began to furnish services, materials, supplies, or other things on or about the ______ day of __________________, 20 ______.2.The undersigned is entitled to a lien against the above-described property for the value of said labor and/or materials. This the ______ day of __________________, 20______. Signature: Name: Address: Notice of Furnishing Page 2 of 2 SERVICE (Name of Person or Entity Served)I, ______________________________, served the above document upon the person or entity named above in the manner set forth below (check one) OWNERCONTRACTOR PERSON IN CHARGE OF THE PROPERTY; specify details: ____________________________________________________________ in the manner set forth below (process server must check proper space and provide all additional information that is requested and pertinent to the mode of service used): FIRST CLASS MAIL By mailing (by first class mail, postage prepaid), on ________________________.PERSONAL SERVICE. I personally delivered copies of the summons and complaint on the ______ day of __________________ , 20______, to: ____________________________________, where I found said person(s) in __________________ County of the State of __________________. CERTIFIED MAIL SERVICE. By mailing, by first class mail, postage prepaid, requiring a return receipt) copies to the person served. Date: Name: Address: