Fill and Sign the On This Day of Before Me the 490245410 Form

Assignment of Lien Page 1 of 2Prepared by, recording requested by and return to:Name: ___________________Company: ____________________Address: ______________________City: ________________________State: _____Zip: _________Phone: _____________________Fax: _____________________Reference # ___________________----------------------Above this Line for Official Use Only--------------------- ASSIGNMENT OF LIEN- CORPORATION Beginning on or about the _____ of _______________, 20_____, __________________________________, the undersigned, as a representative of _________________________________ a _________________________________ corporate lienor, furnished or supplied labor, materials, or laborers to ___________________________________ for the purpose of improvements of real property located at and described as: _________________________________________________________________, such that the undersigned lienor is entitled to a lien for the value of labor, materials, or laborers supplied. Notice is hereby given that the above-mentioned lienor does hereby assign its claim and lien to ___________________________________, who shall hereafter have all the rights and remedies under law to which the lienor is entitled subject to all defenses thereto that might be made if such assignment had not been made, for the purpose of filing and for the enforcement of the above-mentioned lien. This the _____ day of _______________ , 20______. __________________________________Signature__________________________________ Type or Print Name __________________________________Title__________________________________CorporationAttest: Assignment of Lien Page 2 of 2 Secretary STATE OF WASHINGTONCOUNTY OF ________________ On this ______ day of ________________, __________, before me, the undersigned, a Notary Public in and for the State of Washington, duly commissioned and sworn, personally appeared ___________________________________ and __________________________________, to me known to be the ___________________________________ President and ___________________________________ Secretary, respectively, of ___________________________________, the corporation that executed the foregoing instrument and acknowledged the said instrument to be the free and voluntary act of and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that __________________________________ authorized to execute the said instrument and that the seal affixed is the corporate seal of said corporation. Witness my hand and seal the day and year first above written. ______________________________Notary Public residing at _________Printed Name: _________________ My Commission Expires: _______________