Fill and Sign the Notice is Hereby Given that the above Mentioned Lienor Does Hereby Assign His Form

Assignment of Lien Page 1 of 2 Prepared by, recording requested by and return to: Name: ___________________ Company: ____________________ Address: ______________________ City: ________________________ State: _____ Zip: _________ Phone: _____________________ Fax: _____________________ ----------------------Above this Line for Official Use Only--------------------- ASSIGNMENT OF LIEN- INDIVIDUAL Beginning on or about the _____ of _______________, 20_____, the undersigned lienor, __________________________________, furnished or supplied labor, materials, or laborers to ___________________________________ for the purpose of improvements of real property at _________________________________________________________________, such that the undersigned lienor is entitled to a lien for the value of labor, materials, or laborers supplied. Notice is hereby given that the above-mentioned lienor does hereby assign his or her claim and lien to ___________________________________, who shall hereafter have all the rights and remedies under law to which the lienor is entitled subject to all defenses thereto that might be made if such assignment had not been made, for the purpose of filing and for the enforcement of the above-mentioned lien. This the _____ day of _______________, 20______. __________________________________ Signature of Lien Holder__________________________________ Type or Print Name Assignment of Lien Page 2 of 2 STATE OF OKLAHOMA COUNTY OF _____________________ The instrument was acknowledged before me on ___________________ (date), by _________________________________________ (name(s) of person(s)). ______________________________ Notary Public Printed Name: _________________ (SEAL) My Commission Expires: _____________________