Fill and Sign the La Lien Form

NOTICE OF LIEN RIGHTS- INDIVIDUAL (La.Rev.Stats § 4852) Delivered this _____ day of _____________, 20______, by __________________________________, Contractor to ________________________________, Owner for work being performed at the following address: _______________________________ _______________________________ _______________________________. By signing below, I ________________________________, as the owner of residential property located at the address shown above, acknowledge that the above-named contractor has delivered this notice to me, the receipt of which is accepted, signifying my understanding that said contractor is about to begin improving my residential property according to the terms and conditions of a contract, and that in accordance with the provisions of law in Part I of Chapter 2 of Code Title XXI of Title 9 of the Louisiana Revised Statutes of 1950, R.S. 9:4801, et seq.: (1) A right to file a lien against my property and improvements is granted to every contractor, subcontractor, architect, engineer, surveyor, mechanic, cart-man, truckman, workman, laborer, or furnisher of material, machinery or fixtures, who performs work or furnishes material for the improvement or repair of my property, for the payment in principal and interest of such work or labor performed, or the materials, machinery or fixtures furnished, and for the cost of recording such privilege. (2) That when a contract is unwritten and/or unrecorded, or a bond is not required or is insufficient or unrecorded, or the surety therefor is not proper or solvent, I, as owner, shall be liable to such subcontractors, materialmen, suppliers or laborers for any unpaid amounts due them pursuant to their timely filed claims to the same extent as is the hereinabove designated contractor. (3) That the lien rights granted herein can be enforced against my property even though the contractor has been paid in full if said contractor has not paid the persons who furnished the labor or materials for the improvement. (4) That I may require a written contract, to be recorded, and a bond with sufficient surety to be furnished and recorded by the contractor in an amount sufficient to cover the cost of such improvements, thereby relieving me, as owner, and my property, of liability for any unpaid sums remaining due and owing after completion to subcontractors, journeymen, cartmen, workmen, laborers, mechanics, furnishers of material or any other persons furnishing labor, skill, or material on the said work who record and serve their claims in accordance with the requirements of law. I have read the above statement and fully understand its contents. Notice of Lien Rights Page 1 of 2 This the _____ day of ______________, 20_________. ________________________ Signature of Owner or Agent ________________________ 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 Notice of Lien Rights by: Personal Service Mailing a true and correct copy of the same by registered or certified U.S. Mail, postage prepaid, return receipt requested to , who is the Owner located at _________________________________________. Certified or Registered Mail Number(s): . So certified this the ______ day of __________________, 20______. Signature Notice of Lien Rights Page 2 of 2