Fill and Sign the Notice to Owner of Furnishing of Labor or Mateirials Individual Form

Notice to Financial Institution of Furnishing Page 1 of 2 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 2 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: