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Fill and Sign the Notice of Requested Information by Corporation or Llc Arkansas

Fill and Sign the Notice of Requested Information by Corporation or Llc Arkansas

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Notice of Requested Information-Corporation, LLC, etc. (A.C.A. § 18-44-108) COMES NOW, ___________________________________ , as representative of ___________________________________ a ____________________________________ business entity serving as contractor or subcontractor performing improvements on property at ____________________________________ , and would state as follows: 1. On or about the _____ day of ___________ , 20 _____ , a request for information pursuant to Arkansas Code Annotated § 18-44-108 was received by the undersigned. 2. The following is a list of all parties that have furnished labor or materials and are due the following amounts: Party Supplying Amount due __________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ _____________________________________ ___________________________________ ____________________________________. 3. The undersigned hereby certifies that the owner of the above mentioned property undergoing improvements has received a preliminary notice pursuant to §18-44-115 of the Arkansas Code Annotated. This the _____ day of ___________ , 20 _____ . ____________________________________ Name of Company By: __________________________ ______ _ _____ Signature Title ____________________________________ Type or Print Name Notice of Requested Information Page 1 of 2 STATE OF ARKANSAS COUNTY OF _______________ On this the ____ day of ______________, 20__, before me, ____________________________________ , the undersigned officer, personally appeared ____________________________________ , who acknowledged himself to be the ____________________________________ of ____________________________________ , a __________________ corporation or _______________________ , and that he, being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by him/herself as ____________________________________ . In witness whereof I hereunto set my hand and official seal on this ____ day of ______, 20___. ___________________________ NOTARY PUBLIC My Commission Expires: ____________________ AK § 18-44-108 Notice of Requested Information Page 2 of 2

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