Fill and Sign the Form 4669 Abandoned Property Report Missouri

Assignment of Lien Page 1 of 2Prepared by, recording requested by and return to:Name: ___________________Company: ____________________Address: ______________________City: ________________________State: _____Zip: _________Parcel ID Number: ______________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 located at and described as: _________________________________________________________________, (legal description should include the platting information (if property is platted), or if unplatted, then "metes and bounds" tied into the Public Land Survey System; Public Land Survey Information; municipality (e.g Town, Village or City of Paradise); and county) 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__________________________________ Assignment of Lien Page 2 of 2CorporationAttest: Secretary This instrument was drafted by _______________ (name).STATE OF WISCONSINCOUNTY OF ___________________This instrument was acknowledged before me this _____ day of ________________, ______ by _________________________________ who is/are the _________________________________ of ________________________ on behalf of the corporation. ______________________________Notary Public (Seal, if any) Printed Name: _________________ My Commission Expires: _________________ Certificate of Delivery I, ___________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to property owner __________________________________ by: ( )Personal Delivery ( )Mailing a true and correct copy of same by registered U.S. mail, postage prepaid, return receipt requested to _________________________________. So certified this the _____ day of _______________, 20______. ________________________Signature