Fill and Sign the Golden Transcript 0418 by Colorado Community Media Issuu Form

SUBCONTRACTOR'S NOTICE OF RIGHT TO CLAIM A LIEN--INDIVIDUAL (Wyo. Stat. §29-2-111) TO: ________________________________ ________________________________ ________________________________ COMES NOW, _________________________________ , of the following address and telephone number, _______________________________________________________________________ , as a subcontractor or materialman who has performed work or furnished materials for the improvement, the contract value of which is in excess of $50,000, of the property located at and described as ________________________________________________________________________ ______________________________________________________________________ , and would state as follows: 1. The undersigned began providing labor and/or materials under contract for the above-described property on the _____ day of ______________ , 20 ______ . 2. Work was substantially completed or the contract to furnish materials was substantially completed on or about the _____ day of _______________ , 20 ______ . 3. The undersigned has furnished the following labor and/or materials: Labor/Materials Date Cost/Value ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________ . 4. The name of the subcontractor or materialman’s contact person is: _________________________________ . 5. The name and address of the subcontractor or materialman’s vendor, if any, is ________________________________________________________________________ _______________________________________________________________________ . 6. Pursuant to Wyoming Statute § 29-2-111 the undersigned hereby provides notice that the undersigned has a right to claim a lien against the buildings or improvements on the above-described property, or on the real estate itself for services or materials furnished. This the _____ day of ______________ , 20 ______ . Subcontractor’s Notice of Right to Claim a Lien Page 1 of 2 ______________________________ Signature ______ ________________________ Type or Print Name Certificate of Delivery I, __________________________________ , hereby certify that I have delivered this day a true and correct copy of the foregoing to __________________________________ , prime contractor, by: ( ) Personal Service and receipt by prime contractor or his or her agent ( ) Mailing a true and correct copy of same by certified U.S. mail, postage prepaid, return receipt requested to __________________________________ . So certified this the _____ day of ______________ , 20 ______ . ________________________ Signature Subcontractor’s Notice of Right to Claim a Lien Page 2 of 2