Fill and Sign the Construction Lien Notice Individual Form

Construction Lien Notice Page 1 of 3Prepared by, recording requested by and return to:Name: _____________________Company: _____________________Address: ______________________City: ___________________State: _____ Zip: __________Phone: _______________Fax: _________________----------------------Above this Line for Official Use Only--------------------- CONSTRUCTION LIEN NOTICE —INDIVIDUAL (M.C.A. § 71-3-535) COMES NOW, ________________________________, as a party who has furnished services or materials and would state as follows:1.This Lien is filed within ninety (90) days of the final furnishing of services or materials by the undersigned, or within ninety (90) days of the filing of a Notice of Completion by the property owner. 2.Each and every property owner of record has been served a copy of this Lien Notice, so certified by the undersigned in the attached Certificate of Service on Owner.3.I, _______________________________________________________________ (insert name and address of person claiming the construction lien), claim a construction lien pursuant to Title 71, chapter 3, of the Montana Code Annotated. 4.I claim this lien against: ________________________________________________________________________ ____________________________________________________________________________________________________________. [Give description of the real property against which the lien is claimed sufficient to identify it.]5.The contracting owner is _________________________________ (insert name of the person who owns the real estate and name of the person who entered into the contract to improve it). 6.At the request of _______________________________________________________________________ (give name and address of party with whom person claiming the lien contracted to furnish services or materials), I provided the following: Construction Lien Notice Page 2 of 3________________________________________________________________________ ________________________________________________________________________ (give description of the services or materials provided). 7.The estimated amount remaining unpaid is $_______________ (insert the amount unpaid; if no amount was fixed by the contract, give your good faith estimate of the amount and identify it as an estimate). 8.I first furnished these services or materials on the _____ day of ______________, 20______ (give date), and last furnished services or materials on the _____ day of ______________, 20______ (give date; if the date has not yet arrived, insert an estimate of the date on which services or materials will be last furnished and identify the date as an estimate). 9.I gave notice of the right to claim a lien as required by § 71-3-531 on the _____ day of ____________, 20______ (give date), to _________________________________ (give name of contracting owner). (If it is not required to give a notice of the right to claim a lien, state the reason it is not required.) _______________________________________________________________________. This the _____ day of _____________, 20______.______________________________ Signature______________________________ Type or Print NameSTATE OF MONTANACOUNTY OF _______________ The instrument was acknowledged before me on _____________ (date), by __________________________________ (name(s)). ______________________________Notary Public (SEAL)Title (and Rank): _______________ Printed Name: _________________Residing at:____________________ My Commission Expires: ________________ MT § 71-3-536 Construction Lien Notice Page 3 of 3 CERTIFICATE OF SERVICE ON OWNER-INDIVIDUAL (M.C.A. § 71-3-534) I, __________________________________, hereby certify that I have delivered this day a true and correct copy of the attached Lien Notice to each and every owner of record of the property named in said Lien Notice, namely __________________________________, by: ( )Personal Service ( )Mailing a true and correct copy of same by certified U.S. mail, postage prepaid, return receipt requested to ________________________________ at his/her last known address. So certified this the _____ day of _____________, 20 ______.______________________________ Signature______________________________ Type or Print NameState of Montana County of ______________ ________________ (date) Signed and sworn to (or affirmed) before me on _____________ by __________________________________ (name(s) of person(s) making statement). ______________________________Notary Public (SEAL) Title (and Rank): _______________ Printed Name: _________________Residing at:____________________ My Commission Expires: ______________MT § 71-3-534(2)