Fill and Sign the New Requirement for Louisiana Equipment Lessors Levelset Form

Mutual Release of Notice of Contract with Affidavit Page 1 of 2 NOTICE OF LEASE OF MOVABLES - CORPORATION (La.Rev.Stats § 9:4802(G)(1)) Notice Provided To: Summary of Terms of Lease: Name and Address of Party Providing This Notice: Description of Movables or Equipment delivered to the improvement: Address where a lien may be later claimed: Date When Movables Delivered to Site: Term of the Lease: Agreed Rent: $ /hour This notice is provided to you as owner or contractor required by Louisiana Revised Statute 9:4802 (G) within no more than ten (10) days after the above-named party, as a less or of movables, deliver ed the above-described equipment or movables to the above-identified property for use in a work. A summary of the lease terms is provided above, and a copy of the lease agreement is enclosed with this notice. The party providing this notice hereby reserves its right to lien the property in the event it is not paid for the lease of this equipment or movables. Please take steps to protect yourse lf from having a lien ("Statement of Claim and Privilege") placed against your property, a nd possibly having to pay for these movables twice. This the ______ day of __________________, 20 ______ Signature ____________________________________ Type or Print Name ____________________________________ Title ____________________________________ Name of Corporation Mutual Release of Notice of Contract with Affidavit Page 2 of 2 Certificate of Delivery I, , hereby certify that I have delivered this day a true and correct copy of the foregoing to Notice of Lease by: Personal Service Mailing a true and correct copy of the same by Certified or Registered U.S. Mail, postage prepaid, return receipt requested to , who is the Owner located at ___________________________________________ and who is the located at ___________________________________________. Certified or Registered Mail Number(s) : . So certified this the ______ day of __________________, 20______. Signature