Fill and Sign the Notice of Lien Claimcorporation Form

Notice of Lien Claim 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 LIEN CLAIM—Corporation(Colorado Revised Statute §38-22-109(10)) Comes now, (Name) _________________________________ , as President of ________________________________, a __________________________________, corporation, (Address) _______________________________________________________________________, (Telephone Number) _______________________, and hereby provides notice of the following: 1.The above-mentioned corporation has performed labor, or supplied materials or laborers, for the purposes of improvements of property located at: ____________________________________________________________ __________________________________________________________, and is entitled to a lien thereby.2.Said improvements were the result of a contract entered into between the corporation and _____________________________________.3.That the corporation hereby reserves the right to file a lien statement regarding said improvements within four months after completion of improvements or six months after the date of filing of this notice, whichever occurs first. This the _____ day of _____________________ , 20______. __________________________________Name of Corporation President, __________________________ ___________________________________ Type or Print NameAttest: Secretary Notice of Lien Claim Page 2 of 2STATE OF COLORADOCOUNTY OF _____________________ The foregoing instrument was acknowledged before me this _____ day of __________, 20____ by ___________________________(name of officer or agent, title of officer or agent) of ___________________________(name of corporation acknowledging) a __________________ (state or place of incorporation) corporation, on behalf of the corporation. ______________________________Notary Public Printed Name: _________________ My Commission Expires: _____________________CO § 38-22-109(10)