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Fill and Sign the Response to Demand for List of Services Individual Oregon Form

Fill and Sign the Response to Demand for List of Services Individual Oregon Form

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RESPONSE TO DEMAND FOR LIST OF LABOR AND MATERIALS – INDIVIDUAL (OR. Rev. Stat. § 87.027) COMES NOW, ________________________________ , as a party who has supplied labor and/ or material for the improvement of the property located at and described as _______________________________________________________________________ , and would state as follows: 1. On or about the _____ day of ____________ , 20 _______ , the undersigned received a demand for a list of services and other things from the owner of the above- described property, ______________________________________________________ . 2. Pursuant to OR. Rev. Stat. § 87.027 the undersigned hereby provides the requested information: Labor/Material Provided Date Cost/Value ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________ . 3. The following is a statement of the contract terms under which said labor and/or materials was provided: _______________________________________________________________________ . 4. The contract under which said labor and/or materials was provided is approximately ______ % complete. 5. As of the date of the property owner’s demand, the undersigned is owed the sum of $ ______________ for labor and services provided. This the ______ day of _______________ , 20 _______ . _____________________________ Signature _____ ________________________ Type or Print Name Response to Demand for List of Labor and Materials Page 1 of 2 Certificate of Delivery I, _____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ___________________________________ by: ( ) Personal Delivery ( ) Mailing a true and correct copy of same by certified or registered U.S. mail, postage prepaid, return receipt requested. So certified this the ______ day of ___________________, 20____. ________________________ Signature Response to Demand for List of Labor and Materials Page 2 of 2

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