Fill and Sign the Prime Contractors Notice of Intention to File Claim of Lien Individual Wisconsin Form

PRIME CONTRACTOR’S NOTICE OF INTENTION TO FILE CLAIM FOR LIEN -- INDIVIDUAL (§779.06(2), Wis. Stats.) OWNER'S NAME: ________________________________ OWNER'S ADDRESS: ________________________________________________________________________ _______________________________________________________________________ . The undersigned Prime Contractor, having contracted with ________________________________ , (name of party with whom Prime Contractor contracted) provided materials and/or labor for: ________________________________________________________________________ ______________________________________________________________________ (describe work performed) to improve your property located at: ________________________________________________________________________ ________________________________________________________________________ and, as of the date of this Notice, is owed the sum of $ __________________ . Notice is hereby provided that if payment in full is not received within thirty (30) days from the date of this Notice, the Prime Contractor intends to file a Claim for Lien on your Property. This is the _____ day of ________________ , 20 ______ . _____________________________ Signature _____ ________________________ Type or Print Name _____ ________________________ _____________________________ Address Certificate of Delivery I, ___________________________________ , hereby certify that I have delivered this day a true and correct copy of the foregoing to property owner __________________________________ by: ( ) Personal Delivery ( ) Mailing a true and correct copy of same by registered U.S. mail, postage prepaid, return receipt requested to _________________________________ . So certified this the _____ day of _______________ , 20 ______ . ________________________ Signature Prime Contractor’s Notice of Intention to File Claim for Lien Page 1 of 1