Fill and Sign the Notice of Furnishing Professional Services Mechanics Liens Individual Washington Form

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 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 1 of 2 _____ _________________________ City, State, Zip Code _____ _________________________ Phone Number STATE OF WASHINGTON COUNTY 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) Notice of Furnishing Professional Services Page 2 of 2