Fill and Sign the Notice of Furnishing of Labor or Materials Corporation Form

Notice of Furnishing of Labor or Materials Page 1 of 3Prepared by, recording requested by and return to:Name: _________________Company: __________________Address: ___________________City: ________________State: ______Zip: _________Phone: _______________Fax: ________________----------------------Above this Line for Official Use Only---------------------NOTICE OF FURNISHING OF LABOR OR MATERIALS – CORPORATION (S.D. Codified Laws Ann. § 44-9-53) TO CONTRACTOR: _____________________________________________________ (NAME/ADDRESS) ANDOWNER: _______________________________________________________________ (NAME/ADDRESS)COMES NOW, ___________________________________, as a representative of ___________________________________ a _________________________________ corporate sub-contractor, or corporate supplier to sub-contractors, which has furnished 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 actually furnished or is scheduled to furnish the first item of labor and/or materials on the _____ day of _____________, 20_______, and ceased, or will cease, providing labor and/or materials for the improvement of the above described property on the _____ day of _____________, 20_______.2.The undersigned contracted with or was employed by ______________________.3.A description of the labor, services, or materials furnished and the contract price or value thereof is as follows:labor/services/materials datecost/value________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________. Notice of Furnishing of Labor or Materials Page 2 of 34. A description of the project is as follows: _______________________________________________________________________.5.The undersigned is due the amount of $ _______________.6.A copy of this notice has been provided to the project’s principal contractor and to the property owner of record by certified or registered mail. Post office receipts evidencing said mailings are attached hereto. This the _____ day of _____________, 20______. ________________________Signature ________________________ Type or Print Name________________________Title________________________Corporation Attest: Secretary State of South DakotaCounty of __________________On this , the ______ day of ____________ , 20______ , before me, ______________________________ , the undersigned officer, personally appeared ______________________________ , who acknowledged himself to be the ____________ of ________________________ , a corporation, and that he/she, as such ________________________ being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself/herself as __________________. In witness whereof I hereunto set my hand and official seal.Notary Public, State of ____________My commission expires: Type or Print Name Notice of Furnishing of Labor or Materials Page 3 of 3 Certificate of Delivery I, ____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ____________________________________ by 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