Fill and Sign the Notice of a Right to a Liencorporation or Llc Form

Notice of a Right to a Lien Page 1 of 2Prepared by, recording requested by and return to:Name: ____________________Company: ___________________Address: _____________________City: _______________________State: ________Zip: _________Phone: ___________________Fax: _____________________ ----------------------Above this Line for Official Use Only--------------------- NOTICE OF A RIGHT TO A LIEN—CORPORATION or LLC (A.S. § 34.35.064) COMES NOW, _________________________________, as a representative of __________________________________ a _________________________________ business entity whose address is __________________________________, which will furnish labor, material, service, or equipment and would hereby provide Notice of the following:1.This is a notice of a right to assert a lien against real property for labor, materials, services, or equipment furnished in connection with a project.2.The undersigned corporation will furnish labor, material, services, or equipment for the improvement of the property located at and legally described as: ____________________________________________________________________________.3.Said property is owned by _________________________________.4.The undersigned corporation contracted to furnish labor, material, services, or equipment with __________________________________ of the following address: _________________________________.5.The following is a general description of the labor, material, services, or equipment provided or to be provided: ____________________________________. 6.The undersigned would hereby provide Notice that the undersigned may be entitled to record a claim of lien as a result of the furnishing of the above-mentioned labor, material, services, or equipment. Notice of a Right to a Lien Page 2 of 2WARNING: Unless provision is made for payment of sums that may be due to the undersigned, your above property may be subject to foreclosure to satisfy those sums even though you may pay a prime contractor or other person for the labor, material, service, or equipment furnished by the undersigned. This the _____ day of _____________, 20______. _________________________Name of Corporation, LLC or partnershipBy: _________________________________ _____ Signature Title _________________________Type or Print NameAttest: Secretary 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 ( )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