Fill and Sign the Contingent Payment Clauses in the American Form

Subcontractor’s Statement of Account Page 1 of 3 SUBCONTRACTOR’S STATEMENT OF ACCOUNT --INDIVIDUAL (N.H. Rev. Stat. Ann. § 447:8) [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 subcontractor who has supplied labor and/or material for the improvement of the property located at and described as: , and would state as follows: 1. From the ______ day of __________________, 20______, to the ______ day of __________________, 20______, the undersigned supplied the following labor/and or materials: labor/materials date cost/value Subcontractor’s Statement of Account Page 2 of 3 2. Amount claimed since last Statement of Account: $ ____________ 3. Total Amount Claimed including this Statement of Account: $ ____________ This the ______ day of __________________, 20______, Signature: Name: Address: Subcontractor’s Statement of Account Page 3 of 3 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) OWNER CONTRACTOR 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. Signature: Name: Address: