Fill and Sign the Filing and for the Enforcement of the above Mentioned Lien Form

Assignment of Lien Page 1 of 2 Prepared by, recording requested by and return to: Name: ___________________ Company: ____________________ Address: ______________________ City: ________________________ State: _____ Zip: _________ Phone: _____________________ Fax: _____________________ ----------------------Above this Line for Official Use Only--------------------- ASSIGNMENT OF LIEN- CORPORATION Beginning on or about the _____ of _______________, 20_____, __________________________________, the undersigned, as a representative of _________________________________ a _________________________________ corporate lienor, furnished or supplied labor, materials, or laborers to ___________________________________ for the purpose of improvements of real property at _________________________________________________________________, such that the undersigned lienor is entitled to a lien for the value of labor, materials, or laborers supplied. Notice is hereby given that the above-mentioned lienor does hereby assign its claim and lien to ___________________________________, who shall hereafter have all the rights and remedies under law to which the lienor is entitled subject to all defenses thereto that might be made if such assignment had not been made, for the purpose of filing and for the enforcement of the above-mentioned lien. This the _____ day of _______________, 20______. __________________________________ Signature__________________________________ Type or Print Name __________________________________ Title__________________________________ Corporation Attest: Assignment of Lien Page 2 of 2 Secretary State of Vermont County of ___________________ I, _________________________________, a notary public in and for the state and county aforesaid, do certify that _______________________________ (or _____________________________ and _______________________________), whose name (or names), as _______________________________ (or _______________________________ and ________________________________) of ___________________________________ (insert name of corporation), is (or are) signed to the writing above, bearing date on the _____ day of ___________________, ________, has (or have) acknowledged the same before me in the county aforesaid. Given under my hand and seal this _____ day of ___________________, ________. ___________________________________ Notary Public, State of Printed Name: _______________________ My Commission Expires: ___________________