Fill and Sign the Notice of Claim Individual Tennessee Form

Notice of Claim -- Individual (Tenn. Code Ann. § 66-11-143(e)(1)) COMES NOW, ______________________________ , as a prime contractor or remote contractor who has provided labor and/or materials for the improvement of the property located at and described as _____________________________________________________________________ , and would provide notice of the following: 1. The undersigned lien claimant is in receipt of a notice stating the completion of work on the above-described property. 2. The undersigned has not previously registered a contract as provided in Tenn. Code Ann. §66-11-111 pertaining to the above-described property and any labor and/or materials to be provided. 3. The undersigned has not registered a sworn statement as provided in Tenn. Code Ann. §66-11-112. 4. The undersigned hereby claims a lien in the amount of $ ____________ ( ________________________ Dollars), and certifies that this claim does not include any amount owed to the claimant on any other job or under any other contract. This the ______ day of __________________ , 20 ______ , _________________________ Signature _____ ____________________ Type or Print Name Certificate of Delivery I, ______________________________ , hereby certify that I have delivered this day a true and correct copy of the foregoing to ________________________ by: Personal Service Mailing a true and correct copy of same by certified or registered U.S. mail, postage prepaid, return receipt requested to ______________________________ . So certified this the ______ day of __________________ , 20 ______ . ________________________ Signature Notice of Claim Page 1 of 1