Fill and Sign the Notice of Possible Mechanics Lien Corporation Form

Notice of Possible Mechanic’s Lien Page 1 of 1 NOTICE OF POSSIBLE MECHANIC’S LIEN - CORPORATION (R.I. Gen. Laws §34-28-4.1) To: _________________________________. (insert name of owner, lessee or tenant, or owner of less than the fee simple). The undersigned is about to perform work and/or furnish materials for the construction, erection, alterations, or repair upon the land at ________________________________________________________________________ under contract with you. This is a notice that the undersigned and any other persons who provide labor and materials for the improvement under contract with the undersigned may file a mechanic’s lien upon the land in the event of nonpayment to them. It is your responsibility to assure yourself that those other persons under contract with the undersigned receive payment for their work performed and materials furnished for the construction, erection, alteration or repair upon the land. _______________________________ Signature_______________________________ Type or Print Name_______________________________ Title _______________________________ Name of Corporation______________________________________________________________ Address 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 U.S. mail, postage prepaid, return receipt requested to __________________________________. So certified this the _____ day of _____________, 20______. ________________________ Signature