Fill and Sign the Materialmans Lien Notice General Arkansas Form

After Recording Return to: __________________________________ ___________________________________ ____________________________________ ___________________________________ ) ) ) ) ) ) ) ) -------- Above This Line Reserved For Official Use Only---------------- MATERIALMAN'S LIEN NOTICE TO: __________________________________ (name) __________________________________ (address) NOTICE is hereby given that the undersigned has asserted a lien against the following real property described legally as: _____________________________________ together with the building thereon, which is the property of __________________________________ to secure the sum of $ ____________________________________ due to the undersigned by ________________________________________ for material (or labor) furnished for and used in the construction of __________________________________ , (type of building) located on said property. You are further notified that on or after the _____ day of __________________ , 20 _______ , the undersigned will file with the Clerk of the Circuit Court of _______________________________________ County, Arkansas, an account of the said sums due to the undersigned pursuant to the laws pertaining to the enforcement of mechanic's and materialman's liens and thereby enforce payment of this indebtedness against the above described property. This _____ day of _______________ , 20 ______ . ________________________________ Signature [claimant] Materialman’s Lien Notice Page 1 of 4 _____ ___________________________ Print or Type Name _____ ___________________________ ________________________________ Address STATE OF ARKANSAS COUNTY OF _________________ On this the ____ day of __________, 20__, before me, ____________________, the undersigned officer, personally appeared__________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. In witness whereof I hereunto set my hand and official seal on this ____ day of ______, 20___. ___________________________ NOTARY PUBLIC My Commission Expires: ____________________ STATE OF ARKANSAS COUNTY OF _________________ On this the ____ day of __________, 20__, before me, ____________________, the undersigned officer, personally appeared__________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained. In witness whereof I hereunto set my hand and official seal on this ____ day of ______, 20___. ___________________________ NOTARY PUBLIC My Commission Expires: ____________________ Materialman’s Lien Notice Page 2 of 4 Materialman’s Lien Notice Page 3 of 4 IMPORTANT NOTICE I UNDERSTAND THAT PERSONS SUPPLYING MATERIAL ARE ENTITLED TO A LIEN AGAINST PROPERTY IF THEY ARE NOT PAID IN FULL FOR MATERI ALS USED TO IMPROVE THE PROPERTY EVEN THOUGH THE FULL CONTRACT PRICE MAY HAVE BEEN PAID TO THE CONTRACTOR. I REALIZE THAT THIS LIEN CAN BE ENFORCED BY THE SALE OF THE PROPERTY IF NECESSARY. I AM ALSO AWARE THAT PAYMENT MAY BE WITHHELD TO THE CONTRACTOR IN THE AMOUNT OF THE COST OF ANY MATERIALS OR LABOR NOT PAID FOR. I KNOW THAT IT IS ADVISABLE TO, AND I MAY, REQUIRE THE CONTRACTORS TO FURNISH TO ME A TRUE AND CORRECT FULL LIST OF ALL OF HIS SUPPLIERS UNDER THE CONTRACT, AND I MAY CHECK WITH THEM TO DETERMINE IF ALL MATERIALS FURNISHED FOR THE PROPERTY HAVE BEEN PAID FOR. I MAY ALSO REQUIRE THE CONTRACTOR TO PRESENT LIEN WAIVERS BY ALL SUPPLIERS STATING THAT THEY HAVE BEEN PAID IN FULL FOR SUPPLIES PROVIDED UNDER THE CONTRACT, BEFORE I PAY THE CONTRACTOR IN FULL. I, THE UNDERSIGNED OWNER OR AUTHORIZED AGENT OF THE OWNER, HEREBY ACKNOWLEDGE RECEIPT OF THIS NOTICE AND, HAVING READ IT, Am ADVISED OP ITS CONTENTS. SIGNED: ____________________________________ ______________________________ ADDRESS OF PROPERTY Date: _____________ I HEREBY CERTIFY THAT THE SIGNATURE ABOVE IS THAT OF THE OWNER OR AGENT OF THE OWNERS OF THE PROPERTY AT THE ADDRESS SET OUT ABOVE. ___________________________________ CONTRACTOR Materialman’s Lien Notice Page 4 of 4