Fill and Sign the Kansas Llc Company Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ___________________ Company: ____________________ Address: ______________________ City: ________________________ State: _____ Zip: _________ Phone: _____________________ Fax: _____________________ ASSIGNMENT OF LIEN- CORPORATION Kan. Stat. Ann. §60-1104 Beginning on or about the _____ of _______________ , 20 _____ , __________________________________ , the undersigned, as a representative of _________________________________ a _________________________________ corporate lien claimant, furnished or supplied labor, materials, or laborers to ___________________________________ for the purpose of improvements of real property at _________________________________________________________________ , such that the undersigned lien claimant is entitled to a lien for the value of labor, materials, or laborers supplied. Notice is hereby given that pursuant to Kan. Stat. Ann § 60-1104 the above- mentioned lien claimant does hereby assign the undersigned’s claim and lien to ___________________________________ , who shall hereafter have all the rights and remedies under law to which the lien claimant 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 _____ _________________________ Corporation Attest: Assignment of Lien Page 1 of 2 Secretary Acknowledgment of Corporation STATE OF KANSAS COUNTY OF ___________________ This instrument was acknowledged before me on __________________________ (date) by ___________________________________________ [name(s) of person(s)] as _____________________________________________________ (type of authority, e.g., officer, trustee, etc.) of _____________________________________ (name of party on behalf of whom instrument was executed.) _____________________________ Notary Public _____________________________ Type or Print Name ______________________________ Title (and Rank) (Seal, if any) My appointment expires: _____________________ KS § 60-1104 Assignment of Lien Page 2 of 2