Fill and Sign the North Carolina Notice of Claim Subcontractor 12or 3rd Tier Corporation or Llc Form

Notice of Claim of Lien Page 1 of 2 NOTICE OF CLAIM OF LIEN BY FIRST, SECOND OR THIRD TIER SUBCONTRACTOR - CORPORATION (N.C. Gen. Stat. § 44A-19) To: 1.______________________________________________________________________ _______________________________________________________________________, owner of property involved. (Name and address) 2.______________________________________________________________________ _______________________________________________________________________, general contractor. (Name and address) 3.______________________________________________________________________ _______________________________________________________________________, first tier subcontractor (Name and address) against or through whom subrogation is claimed, if any. 4.______________________________________________________________________ _______________________________________________________________________, second tier subcontractor (Name and address) against or through whom subrogation is claimed, if any. General description of real property where labor performed or material furnished: _______________________________________________________________________________________________________________________________________________________________________________________________________________________ General description of undersigned lien claimant's contract including the names of the parties thereto: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. The amount of lien claimed pursuant to the above described contract: $______________. The undersigned lien claimant gives this notice of claim of lien pursuant to North Carolina law and claims all rights of subrogation to which the claimant is entitled under Part 2 of Article 2 of Chapter 44A of the General Statutes of North Carolina. Dated _______________________ ________________________ Lien Claimant________________________ Type or Print Name Notice of Claim of Lien Page 2 of 2 _________________________ Title_________________________ Corporation ________________________ ________________________ (Address) Certificate of Delivery I, _____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ___________________________________ by: ( ) Personal Service ( ) Mailing a true and correct copy of same by certified or registered U.S. mail, postage prepaid, return receipt requested. So certified this the ______ day of ___________________, 20____. ________________________ Signature