Fill and Sign the Notice Completion Oregon Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ____________________ Company: _____________________ Address: _____________________ City: ________________ State: _____ Zip: __________ Phone: ________________ Fax: _________________ Name of Claimant: ________________________________ Name of Debtor: ________________________________ Amount of Lien: _________________ Tax Assessor’s Account Number: _________________ Situs Address of Real Property: ________________________________________________________________________ NOTICE OF COMPLETION - INDIVIDUAL (Or. Rev. Stat. § 87.045) Notice hereby is given that the building, structure or other improvement on the following described premises, ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (insert the legal description of the property (including the street address, if known), such as a metes and bounds description; a lot, block, subdivision; the book and page and/or instrument number of a recorded deed where the legal can be found; or a parcel in a partition) has been completed. All persons claiming a lien upon the same under the Construction Lien Law hereby are notified to file a claim of lien as required by ORS 87.035. This the _____ day of ______________ , 20 _______ . __________________________________ Original Contractor, Owner or Mortgagee _____ _____________________________ Type or Print Name _____ _____________________________ __________________________________ Address Notice of Completion Page 1 of 1