Fill and Sign the Notice Lien Services Form

Notice of Lien of Launderer or Drycleaner for Services Rendered and of Sale To: ______________________________________________________ Street Address or Post Office Box _____________________________________ _____________________________________________ City, state, and zip code _____________________________________________ _____________________________________________ Notice is hereby given that _________________________________________________ (Name of launderer or drycleaner), the undersigned _____________________________ (launderer or drycleaner), a ________________________________________________ (state) corporation, whose principal place of business is at _________________________ ________________________________________________________________________ ___________________________________ (street address, city, county, state, zip code) , claims a lien on __________________________________________________________ ________________________________________________________________________ __________________________________ ( designate and describe clothing) pursuant to _________________________________________ (cite state statute if applicable) . The undersigned performed the following services regarding said clothing: (describe). _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ ___ These services were completed on ______________________________________ (date) . More than ____days have elapsed since completion of the work, and the described clothing still remains unclaimed and in the possession of the undersigned. These services were performed by the undersigned pursuant to an oral agreement with you for the agreed upon and/or reasonable charge of $_____________. After deducting all just offsets and credits, the amount now due and still owing to the undersigned from you is $ ________________. Notice is further given that the undersigned will sell the described property at __________________________________________________________ (place of sale) on ___________________________________________ (date), at ____________ ( time) , to pay the described charges, the costs of this notice, and the cost of sale of the property, if the charges and costs are not paid within ____days after the mailing of this notice by certified, with return receipt requested . The cost incurred by the undersigned in giving this notice and selling the described property will be deducted from any money that remains after the satisfaction of the lien. The remainder of the money, if any, will be mailed to you at __________________________________________________________ ________________________________________________________________________ ___________________________________________ ( street address, city, county, state, zip code) . Witness our signature this the _____ day of _____________________________ 20____. ____________________________________ (Name of Launderer of Drycleaner) By: _________________________ (Name and Office in Corporation)