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Request that Contractor Provide Last Known Address of Owner Page 1 of 2 REQUEST THAT CONTRACTOR PROVIDE LAST KNOWN ADDRESS OF OWNER- INDIVIDUAL (Okla. Stat. Ann. § 42-142.6-B.6) COMES NOW, _________________________________, as claimant who is entitled to lien rights for the supply of materials, services, labor or equipment for improvements to property located at and/or legally described as _______________________________________________________________________, and hereby requests that you as original contractor provide to the undersigned the name and last-known address of the owner of the above-described property. If you fail to provide the undersigned with the information requested within five (5) days from the date of receipt of this Request, the pre-lien notice requirement to the owner of the property will be rendered unenforceable. This the _____ day of ______________ , 20______. __________________________________Signature __________________________________Type or Print NameSTATE OF OKLAHOMA COUNTY OF __________________ Subscribed and sworn before me, the undersigned, a Notary Public, in and for said County and State, this the __________ day of _________________, 20___, ___________________________Notary PublicPrint Name: _________________ My commission expires: _____________________ CERTIFICATE OF SERVICE I, (name), certify that I am , and at all times during the service of process was, not less than 18 years of age and not a party to the matter concerning which service was made. I further certify that the service was made === (date) by: Request that Contractor Provide Last Known Address of Owner Page 2 of 2 Certified Mail, return receipt requested: Hand Delivery by the United States Postal Service supported by a delivery confirmation receipt; or By automated transaction pursuant to Section 15-115 of Title 12A of the Oklahoma Statutes. Under penalty of perjury, I declare the foregoing is true and correct. Date: Signature Print Name: Business Address: City: State: Zip: