Fill and Sign the Form Approved Omb No 0560 0120 Wa 51 2 Us Department

Notice of Extension 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--------------------- NOTICE OF EXTENSION —INDIVIDUAL (A.S. § 34.35.080(a)(2)) COMES NOW, ____________________________________, as a lien claimant which has furnished labor, material, services, or equipment for the improvement of the property described as _________________________________, and thereby would state as follows: 1.The undersigned lien claimant recorded an initial claim of lien on _____ day of __________, 20______. The initial claim of lien is recorded in Book __________, Page _______ or Instrument/Serial Number __________ in the office of the recorder in the district in which the real property is situated.2. The current balance owed the undersigned lien claimant is the amount of $_____________________ for labor, material, services, or equipment furnished.3. Pursuant to Alaska Statute § 34.35.080(a)(2), the undersigned lien claimant requests a six-month extension of the binding effect of the initial lien on the real property described above.4.The undersigned lien claimant has recorded this Notice of Extension in the same recording office within the original six-month period after the initial claim of lien was recorded.This the _____ day of ___________, 20______._________________________Signature Notice of Extension Page 2 of 3_________________________Print or Type NameState of Alaska _______________________ Judicial District_______________________ Claimant I, ___________________________________, being first duly sworn, on oath say that I am ________________________________ named in the foregoing claim; that I have heard the claim read, know the contents of it, and believe it is true. _________________________Signature_________________________Print or Type NameState of Judicial District (or County) of or Municipality of The foregoing instrument was acknowledged before me this ________________ (date) by ____________________________ (name of person who acknowledged)._____________________________________Signature of Person TakingAcknowledgment___________________________Title or RankMy Commission Expires: _______________________Serial Number, if any Certificate of Delivery I, _____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ___________________________________ by: Notice of Extension Page 3 of 3( ) Personal Service with signed receipt ( )Mailing a true and correct copy of same by first-class U.S. mail, postage prepaid, return signed receipt requested to ___________________________,So certified this the ______ day of ___________________, 20____. ________________________Signature AK § 34.35.080(a)(2)