Fill and Sign the Lien Information

Request for Lien Information – Corporation, etc. (Ala. Code. § 35-11-219) COMES NOW ,       , as a representative of (Name of Party Executing Request)       a       (Name of Corporation, LLC, Partnership, etc.) (State of Formation/Organization)       , as the owner or proprietor of (Corporation, LLC, Partnership, etc.) the property undergoing improvements at:       , (Street Address)       and would hereby request that the original (City, State, Zip Code) contractor,       , provide a complete list of (Name of Original Contractor) the following: 1. All material men, laborers, and employees who have furnished any material or performed any service, or 2. Who may be under any contract or engagement to furnish any material, or to do or perform any service for such contract for or on such building or improvement, and 3. The terms and price thereof. NOTICE : Failure to furnish requested information, or to pay any material man, subcontractor, laborer, or employee, may result in the forfeiture of any right to liens under Alabama statute. Date:             (Name of Business Entity) (Signature)       (Print or Type Name)       (Office, Position, Rank)       (Street Address)       (City, State, Zip Code) Request for Lien Information Page 1 of 2 Certificate of Delivery I,       , hereby certify that I have delivered this day a true and correct copy of the foregoing to       by: Personal Service with signed receipt Mailing a true and correct copy of same by first-class U.S. mail, postage prepaid, return signed receipt requested to:       (Name)       (Street Address, City, State, Zip Code) Other (specify)       So certified this the       day of       , 20       . (Signature)       (Type or Print Name) Request for Lien Information Page 2 of 2