Fill and Sign the Hawaii Lien 497304308 Form

IN THE CIRCUIT COURT OF THE ________________ CIRCUIT STATE OF HAWAII __________________________________ M.L. No. ______________ LIENOR VS. NOTICE OF MECHANIC’S AND MATERIALMAN’S LIEN ___________________________________ RESPONDENT(S) NOTICE OF MECHANIC’S AND MATERIALMAN’S LIEN NOTICE IS HEREBY GIVEN to the Respondents named above and any other person who has or claims to have an interest in this matter or in the property described in Exhibit A attached hereto, as follows: 1. ________________________________ claims a lien under the provisions of Hawaii Revised Statutes, Chapter 507, Part II, in the principal amount of $ ________________ , together with interest, costs and attorney’s fees, on the property described in Exhibit A, attached hereto, which is hereinafter called the “subject property.” 2. The said lien is claimed for services, materials, equipment and labor furnished by Lienor for ____________________________________________ (describe improvement made to property) on the property described in said Exhibit A. 3. The principal amount of $ __________________ , together with interest, costs and accrued attorney’s fees is presently due and owing to lienor for construction services and materials lienor furnished, which were incorporated and used in the improvement to the real property, located in the City and County of _________________________________ , State of Hawaii, described in Exhibit A. 4. This lien is claimed upon the improvements to the said real property and the real property upon which the said improvements are located. 5. This lien is also claimed upon the interests, if any, of the above-named Respondents and their respective heirs, assignees, personal representatives, successors and assigns, as well as any other persons or entities having an interest in said property. 6. Owner/Respondent _______________________________ is a resident of the City and County of _________________________________ , State of Hawaii and is the owner in fee of the real property described at Exhibit A attached hereto. 7. On or about _____ day of ______________ , 20 ______ , Lienor and Owner/Respondent ________________________________ entered into a contract, a true Notice of Mechanic’s and Materialman’s Lien Page 1 of 2 and correct copy of which is attached hereto as Exhibit B, under the terms of which lienor furnished services, labor, materials, and equipment in connection with improvements to that certain real property described at Exhibit A, attached hereto and made a part hereof by reference. Dated: __________________ , Hawaii, _____ day of _________ , 20 ______ . ____________________________ Signature _____ _______________________ Type or Print Name Capacity _____ ________________ Notice of Mechanic’s and Materialman’s Lien Page 2 of 2