Fill and Sign the Notice of Furnishing Professional Services Form

Notice of Furnishing Professional Services 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 FURNISHING PROFESSIONAL SERVICES INDIVIDUAL TO:Owner That on the _____ day of ________________, 20______, _________________________________ began providing professional services upon or for the improvement of real property legally described as follows: ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________ [Legal Description is mandatory] Assessor’s Property Tax Parcel No./Account No. ________________The general nature of the professional services provided is ________________________________________________________________________ _______________________________________________________________________. The owner or reputed owner of the real property is ________________________. ______________________________ Signature______________________________ Type or Print Name_____________________________ Name of Claimant______________________________ Street Address Notice of Furnishing Professional Services Page 2 of 2______________________________ City, State, Zip Code______________________________ Phone NumberSTATE OF WASHINGTONCOUNTY OF ___________________ On this day personally appeared before me _______________________________, to me known to be the individual(s) described in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the same as his/her/their free and voluntary act and deed, for the uses and purposes therein mentioned. Given under my hand and seal of office this _____ day of _____________, 20_________. ______________________________Notary Public residing at _________Printed Name: _________________ My Commission Expires: ___________________WA § 60.04.034(5)