Fill and Sign the Notice to Financial Institution of Furnishing of Labor or Materials Individual New Hampshire Form

NOTICE TO FINANCIAL INSTITUTION OF FURNISHING OF LABOR OR MATERIALS -- INDIVIDUAL (N.H. Rev. Stat. § 447:12-b)       [Name of Claimant]             [Address of Claimant] To:       [Financial Institution furnishing construction funding]       [Address of Owner or Person in Charge of property] COMES NOW, ______________________________ , as a party who has provided labor and/or materials for the improvement of the property located at and described as ____________________________________________________________ , and would state as follows: 1. The undersigned began will begin to furnish labor and/or materials for the improvement of the above described property on the ______ day of __________________ , 20 ______ . 2. Said labor and/or materials were furnished under agreement with a contractor or subcontractor of the property’s owner, namely, ______________________________ . 3. The undersigned would further provide notice that the undersigned is entitled to a lien against the above-described property for the value of said labor and/or materials. 4. The name and address of the job site is: ____________________________________________________________ . This the ______ day of __________________ , 20 ______ . ___________________________ Signature _____ ______________________ Type or Print Name Notice to Financial Institution of Furnishing Page 1 of 2 SERVICE       (Name of Person or Entity Served) I, ______________________________ , served the above document upon the person or entity named above in the manner set forth below (check one) UPON ____________________________________ , A FINANCIAL INSTITUTION FURNISHING CONSTRUCTION FUNDING; specify details: ____________________________________________________________ in the manner set forth below (process server must check proper space and provide all additional information that is requested and pertinent to the mode of service used): FIRST CLASS MAIL By mailing (by first class mail, postage prepaid), on ________________________ . PERSONAL SERVICE. I personally delivered copies of the summons and complaint on the ______ day of __________________ , 20 ______ , to: ____________________________________ , where I found said person(s) in __________________ County of the State of __________________ . CERTIFIED MAIL SERVICE. By mailing, by first class mail, postage prepaid, requiring a return receipt) copies to the person served. Signature: Name:       Address:                   Notice to Financial Institution of Furnishing Page 2 of 2