Fill and Sign the Mortgage Assignment of Rents and Fixture Filing Form

Materialman’s Lien Notice Page 1 of 3After Recording Return to:________________________________________________________________________________________________))))))))--------Above This Line Reserved For Official Use Only---------------- MATERIALMAN'S LIEN NOTICE Electrical Repairman TO: ___________________________________ (name) _____________________________________ (address) NOTICE is hereby given that the undersigned has asserted a lien against the following legally described real property: _____________________________________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 if no response or objection is filed within 10 days any lien obtained shall take precedence over any lien or mortgage of any person notified. This ____ day of _________________, 20______.________________________________Signature [claimant] ________________________________ Print or Type Name Materialman’s Lien Notice Page 2 of 3 ________________________________ ________________________________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 3 of 3IMPORTANT NOTICEI 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 OF 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