Fill and Sign the Notice of Furnishing Absent Contract Corporation Form

Notice of Furnishing Absent Contract Page 1 of 2 Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only-- ------------------- Name: ____________________ Company: _____________________ Address: _____________________ City: ________________ State: ______ Zip: _________ Phone: ________________ Fax: __________________ Notice of Furnishing Absent Contract - Corporation (M.R.S.A. § 3253) COMES NOW, ________________________________, as representative of __________________________________ a __________________________________ corporation which has provided labor, materials, or services toward the improvement of property described as _______________________________________________________________________, and owned by __________________________________, and would state as follows: 1. The undersigned corporation provided the following labor, materials, or services for the improvement of the above-mentioned property without the benefit of a contract with the property owner: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _______________________________________. 2. The undersigned corporation ceased providing labor, materials, or services on the _____ day of _________________, 20_______, being within ninety (90) days of the filing of this document. 3. The undersigned corporation is entitled to a lien in the amount of $_____________ in compensation for labor, materials, or services provided after giving due credit for payments received. 4. That pursuant to Maine Revised Statute Annotated §3253 any attempt by the property owner to deny responsibility for labor, materials, or services furnished without a contract and dissolve the lien of the undersigned should be denied. Notice of Furnishing Absent Contract Page 2 of 2 _____________________________ Signature ______________________________ Type or Print Name ______________________________ Title ______________________________ Corporation Attest: Secretary Date _______________________ State of Maine County of __________________ The foregoing instrument was acknowledged before me this the ___ day of ___________, 20____ by _______________________, of______________________ (name of corporation acknowledging) a _________________________(state or place of incorporation) corporation, on behalf of the corporation). ___________________________________ Signature of Notary Public ____________________________________ Name of Notary Public Notary Public, State of Maine My commission expires: ____________________