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Fill and Sign the Sworn Statement State of Michigan Ss County Form

Fill and Sign the Sworn Statement State of Michigan Ss County Form

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Written Demand to Withhold Funds Page 1 of 1 WRITTEN DEMAND TO WITHHOLD FUNDS --INDIVIDUAL (M.S.A. § 570.1110( 7)) COMES NOW, _________________________________ , being a contractor providing improvements to the property located at __________________ _____________________________________________________ , and would state as follows: 1. The undersigned contractor has provided a sworn statement listing subcontractors, suppliers, laborers, and the amounts they are owed for services. 2. Further, it is the request of the undersigned contractor that pursuant to Michigan Statute Annotated § 570.1110( 7) that the owner, lessee, or agent thereof, withhold from the amount which is due or to become due to the contractor or to the subcontractor for work already performed, an amount sufficient to pay all sums which are due to subcontractors or to su ppliers or to laborers, as shown by the attached Sworn Statement, or which is due to lien claimants who have provided a Notice of Furnishing. This the _____ day of ______________ , 20 ________ . ________________________ Contractor _____ ___________________ Type or Print Name MI § 570.1110

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