Fill and Sign the Stop Notice to Form

Stop Payment Notice By Subcontractor to the Holder of Construction Project Funds To: Bank _________________________________________________ Street Address or Post Office Box _____________________________________ _________________________________________________ City, state, and zip code ______________________________________________ _______________________________________ This notice is given by _______________________________________ (Contractor), a ______________________________ (e.g., roofing) contractor licensed under the laws of _____________________________________________ (state) , referred to herein as Claimant. On ______________________________ ( date) , Claimant entered into a contract with _________________________________________________ (Corporation), as general contractor on a construction project, to furnish labor and materials in connection with construction of a house on property owned by ___________________________________________ (Owner), of __________________ ________________________________________________________________________ ________________________________ (street address, city, county, state, zip code) . The property is described as follows: (Legal Description of Property) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ A copy of the contract is attached hereto as Exhibit A and made a part of this notice. Pursuant to the contract, Claimant has supplied or performed labor and has furnished materials to the project as follows: Date(s) Description Value Total ______________ _________________________________ _______ ______ ______________ _________________________________ _______ ______ ______________ _________________________________ _______ ______ Claimant is informed and believes that you hold funds to be used for the payment of the costs incurred on the aforementioned project. There not being any credits or offsets , there remains unpaid and owing from __________________________________ _______________________ (Corporation) to Claimant the sum of $______________. Payment was due on __________________________ (date) , but said general contractor has refused and still refuses to pay Claimant the amount due and owing. Pursuant to _________________________________ (cite appropriate statute) , Claimant hereby notifies you of Claimant's right to payment of the claim for $_____________ out of any sums now payable, or that may subsequently become payable, by you to _______________________________________________________ (Corporation) as such general contractor with respect to the aforementioned project, and Claimant requests that you withhold sufficient funds to satisfy this claim. Witness my signature this the _____ day of ________________________, 20___. ______________________________ Claimant Acknowledgement (if required)