Fill and Sign the Wisconsin Claim Online Form

      Document Number       Document Title Recording Area Name and Return Address                         Parcel Identification Number (PIN) SUBCONTRACTOR 1 CLAIM FOR LIEN- INDIVIDUAL §779.06, Wis. Stats. NOTE: This Claim for Lien must be docketed with the Clerk of Courts in the County where the Property is located. A copy of this claim must be served on the Owner of the property within thirty (30) days after filing the claim. Date:       To the Clerk of Circuit Court for       County, State of Wisconsin: 1. Claimant's Name:       Claimant's Address:                   Claimant is a corporation limited liability company partnership sole proprietorship individual assignee other:       1 A Subcontractor is anyone who performs, furnishes, or procures labor, services, materials, plans and/or specifications to improve Owner’s property under a contract with any party except the Owner of the property being improved. See §779.02(2)(b), Wis. Stats. Subcontractor Claim for Lien Page 1 of 4 (specify) 2. Owner(s) Name(s):       Owner Address:                   3. Legal Description of Owner's Property improved by Claimant is:  attached to this Claim for Lien  described as:                   located in       County, Wisconsin, and more commonly known as:       (street address) 4. Description of labor, services, materials, plans or specifications performed, furnished or procured by Claimant to improve Owner's Property:             under a written contract dated:       other (specify):       5. Date of first visible commencement of the entire work of improvement on the Property (whether by Claimant or others):       6. Date Claimant first furnished labor or materials:       7. Date Claimant last furnished labor or materials:       8. Subcontractor’ Identification Notice was (check as applicable):  Given to Owner by hand delivery, registered mail, certified mail, or other service requiring written confirmation of receipt within sixty (60) days after first furnishing labor, services, materials, plans and/or specifications.  Not given to Owner because (check one):  This was residential construction of more than a four-family building.  This was non-residential construction.  Prime Contractor 2 , or its officer(s) or controlling shareholder(s) that hired Subcontractor Claim for Lien Page 2 of 4 2 A Prime Contractor means “1. A person, other than a laborer, but including an architect, professional engineer, construction manager, surveyor, or other service provider, employed by the owner, who enters into a contract with an owner of land who is not personally the prime contractor as defined in subd. 2. to improve the land, or who takes over from a prime contractor the uncompleted contract. 2. An owner of land who acts personally as prime contractor in improving such land.” See, § 779.01(2)(d), Wis. Stats. Subcontractor Claim for Lien Page 3 of 4 C E R T I F I C A T E O F S E R V I C E I, ________________________ , do hereby certify that on (date) a true and correct copy of the above and foregoing ________________________ was served upon ______________________________ by: Personal Service Mailing a copy of the above document by certified mail, return receipt requested, to ________________________ at the following address: ________________________ ________________________ Mailing a copy of the above document by registered mail, return receipt requested, to ________________________ at the following address: ________________________ ________________________ So certified this the ______ day of ___________________, 20____. Signature       Print/Type Name Subcontractor Claim for Lien Page 4 of 4