Fill and Sign the Notice Completion Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ____________________ Company: ____________________ Address: _____________________ City: _______________________ State: ______ Zip: _________ Phone: ____________________ Fax: ____________________ NOTICE OF COMPLETION--INDIVIDUAL (A.S. § 34.35.071) COMES NOW, ___________________________________ , as the owner of the real property undergoing improvements located at and described as ____________________________________________________________________________ , and would hereby provide Notice of the following: 1. The improvements on the above-described property were completed on or about the ____ day of ____________ , 20 ______ . 2. The above-described property is owned by __________________________________ , of the following address: ___________________________________ . 3. The nature of the interest or estate of the Owner is described as _____________________________________ . 4. The general contractor on the project was ___________________________________ . NOTICE: The filing of a Notice of Completion affects the time within which a party who has supplied labor, services, material, or machinery may file a Claim of Lien. Notice of Completion Page 1 of 3 This the ____ day of _______________ , 20 ______ . _________________________ Signature _______ __________________ Print or Type Name State of Alaska _______________________ Judicial District _______________________ Claimant I, ___________________________________, being first duly sworn, on oath say that I am ________________________________ named in the foregoing claim; that I have heard the claim read, know the contents of it, and believe it is true. _________________________ Signature _____ ____________________ Print or Type Name State of Judicial District (or County of or Municipality of The foregoing instrument was acknowledged before me this (date) by (name of person who acknowledged). Signature of Person Taking Acknowledgment Title or Rank My Commission Expires: Serial Number, if any Certificate of Delivery I, _____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ___________________________________ by: ( ) Personal Service with signed receipt Notice of Completion Page 2 of 3 ( ) Mailing a true and correct copy of same by first-class U.S. mail, postage prepaid, return signed receipt requested to ___________________________, So certified this the ______ day of ___________________, 20____. ________________________ Signature AK § 34.35.071 Notice of Completion Page 3 of 3