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Fill and Sign the How to Fill Out Blanket Sales Tax Exemption Certificate Form

Fill and Sign the How to Fill Out Blanket Sales Tax Exemption Certificate Form

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Public Demand for Payment Page 1 of 1 PUBLIC DEMAND FOR PAYMENT – CORPORATION (§779.15(3), Wis. Stats.) 1. CLAIMANT: _________________________________ Name: _________________________________ Address: ____________________________________________________ 2. PUBLIC ENTITY: _________________________________ (State/County/Town/Municipality/Other) 3. DATE OF CLAIM FOR PUBLIC IMPROVEMENT LIEN: The _____ day of ______________, 20______. 4. PROJECT NUMBER: ________________________________. 5. AMOUNT CLAIMED: $ __________________. 6. DATE OF SERVICE ON PRIME CONTRACTOR: _____________________ (attachment of a copy of Claim for Public Improvement Lien and Registered Mail Return Receipt or Affidavits of Hand Delivery recommended) Claimant has filed a valid Claim for Public Improvement Lien on the above date, and, to the best of Claimant's knowledge, Prime Contractor has not disputed this Claim within thirty (30) days after service on the Prime Contractor. Therefore, Claimant makes demand on the Public Entity for immediate payment pursuant to §779.15(1), Wis. Stats. This the _____ day of _______________, 20______. __________________________________ Signature__________________________________ Type or Print Name__________________________________ Title__________________________________ Corporation

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