Fill and Sign the New Hampshire Account Form

SUBCONTRACTOR’S STATEMENT OF ACCOUNT --INDIVIDUAL (N.H. Rev. Stat. Ann. § 447:8)       [Name of Claimant]             [Address of Claimant] To:       [Name of Owner or Person in Charge of property]       [Address of Owner or Person in Charge of property] To:       [Name of Contractor]       [Address of Contractor] COMES NOW, ____________________________________ , as a subcontractor who has supplied labor and/or material for the improvement of the property located at and described as:       , and would state as follows: 1. From the ______ day of __________________ , 20 ______ , to the ______ day of __________________ , 20 ______ , the undersigned supplied the following labor/and or materials: labor/materials date cost/value                                                                                                                               Subcontractor’s Statement of Account Page 1 of 3                   2. Amount claimed since last Statement of Account: $ ____________ 3. Total Amount Claimed including this Statement of Account: $ ____________ This the ______ day of __________________ , 20 ______ , Signature: Name:       Address:                   Subcontractor’s Statement of Account Page 2 of 3 SERVICE       (Name of Person or Entity Served) I, ______________________________ , served the above document upon the person or entity named above in the manner set forth below (check one) OWNER CONTRACTOR PERSON IN CHARGE OF THE PROPERTY ; specify details: ____________________________________________________________ in the manner set forth below (process server must check proper space and provide all additional information that is requested and pertinent to the mode of service used): FIRST CLASS MAIL By mailing (by first class mail, postage prepaid), on ________________________ . PERSONAL SERVICE. I personally delivered copies of the summons and complaint on the ______ day of __________________ , 20 ______ , to: ____________________________________ , where I found said person(s) in __________________ County of the State of __________________ . CERTIFIED MAIL SERVICE. By mailing, by first class mail, postage prepaid, requiring a return receipt) copies to the person served. Signature: Name:       Address:                   Subcontractor’s Statement of Account Page 3 of 3