Fill and Sign the Lis Pendens Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ___________________ Company: ____________________ Address: _____________________ City: ____________________ State: _____ Zip: __________ Phone: _________________ Fax: _________________ NOTICE OF LIS PENDENS - INDIVIDUAL (R.I. Gen. Laws § 34-28-11) All persons are hereby notified that the undersigned this day has filed or will file within seven (7) days hereafter, in the superior court for _________________________ County, a complaint to enforce a mechanics' lien against (here insert name of the person against whom the complaint has been or will be filed and his or her relationship to the land), ________________________________ concerning land described as follows: ________________________________________________________________________ _______________________________________________________________________ . The undersigned asserts that there is due to him or her the sum of $ ____________ , under the mechanics' lien, which is based upon a notice of intention, under § 34-28-4 of the mechanics' lien law, mailed to (here insert name and address of person to whom mailing was made) _______________________________________________________________________ , on the _____ day of _____________ , 20 _______ , and filed in the records of land evidence of the city or town of _________________________ , on the _____ day of ______________ , 20 _______ . The attorney for the undersigned is (here insert name and address of attorney) _______________________________________________________________________ . ________________________________ Signature _____ ___________________________ Type or Print Name _____ __________________________ ________________________________ Address Notice of Lis Pendens Page 1 of 1