Fill and Sign the Notice of Claim Subcontractor 12or 3rd Tier Corporation or Llc North Carolina Form

NOTICE OF CLAIM OF LIEN BY FIRST, SECOND OR THIRD TIER SUBCONTRACTOR - CORPORATION (N.C. Gen. Stat. § 44A-19) To: 1. ______________________________________________________________________ _______________________________________________________________________ , owner of property involved. (Name and address) 2. ______________________________________________________________________ _______________________________________________________________________ , general contractor. (Name and address) 3. ______________________________________________________________________ _______________________________________________________________________ , first tier subcontractor (Name and address) against or through whom subrogation is claimed, if any. 4. ______________________________________________________________________ _______________________________________________________________________ , second tier subcontractor (Name and address) against or through whom subrogation is claimed, if any. General description of real property where labor performed or material furnished: ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________ General description of undersigned lien claimant's contract including the names of the parties thereto: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _______________________________________ . The amount of lien claimed pursuant to the above described contract: $ ______________ . The undersigned lien claimant gives this notice of claim of lien pursuant to North Carolina law and claims all rights of subrogation to which the claimant is entitled under Part 2 of Article 2 of Chapter 44A of the General Statutes of North Carolina. Dated _______________________ ________________________ Lien Claimant _____ ___________________ Notice of Claim of Lien Page 1 of 2 Type or Print Name _____ ____________________ Title _____ ____________________ Corporation _____ ___________________ ________________________ (Address) 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. So certified this the ______ day of ___________________, 20____. ________________________ Signature Notice of Claim of Lien Page 2 of 2