Fill and Sign the Mechanics Lien Services Form

Pre-Lien Notice to Owner Regarding Potential Mechanic's Lien for Services to be Provided to General Contractor To: (Owner) __________________________________________________________________________ Street Address or Post Office Box _____________________________________ _______________________________________________________________________ _ City, state, and zip code _____________________________________________ _______________________________________________________________________ _ Pursuant to______________________________ (statute) , notice is given that the undersigned, ______________________________________________ (Contractor) of ________________________________________________________________________ ___________________________________ ( street address, city, county, state, zip code) , by Agreement dated _____________________________________ (date) , has contracted to provide _______________________________________ (e.g., labor and materials) to ________________________________________________________________ (place of construction) , as general contractor, to assist said general contractor in ______________ _________________________________________ ( e.g., the construction of a house) on your property at __________________________________________________________ _______________________________________________________ ( street address, city, county, state, zip code) , which property is more particularly described as follows: ( insert legal description) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ For the furnishing of the above services, there will become due from said general contractor to the undersigned the sum of $____________. The undersigned, pursuant to _______________________________________ (statute) , will claim a lien against the described property on failure of said general contractor to make timely payment. Witness my signature this the _____, day of _____________________, 20_____. ____________________________________ CONTRACTOR