Fill and Sign the Wy Stat29 10 101 29 10 101 Preliminary Notice of Right Form

Subcontractor’s Notice of Right to Claim a Lien Page 1 of 2SUBCONTRACTOR'S NOTICE OF RIGHT TO CLAIM A LIEN--INDIVIDUAL (Wyo. Stat. §29-2-111) TO: ________________________________ ________________________________________________________________ COMES NOW, _________________________________, of the following address and telephone number, _______________________________________________________________________, as a subcontractor or materialman who has performed work or furnished materials for the improvement, the contract value of which is in excess of $50,000, of the property located at and described as ________________________________________________________________________ ______________________________________________________________________, and would state as follows: 1.The undersigned began providing labor and/or materials under contract for the above-described property on the _____ day of ______________, 20______.2. Work was substantially completed or the contract to furnish materials was substantially completed on or about the _____ day of _______________, 20______.3. The undersigned has furnished the following labor and/or materials: Labor/Materials DateCost/Value________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________ _______________________________________________________________________.4.The name of the subcontractor or materialman’s contact person is: _________________________________.5.The name and address of the subcontractor or materialman’s vendor, if any, is ________________________________________________________________________ _______________________________________________________________________.6. Pursuant to Wyoming Statute § 29-2-111 the undersigned hereby provides notice that the undersigned has a right to claim a lien against the buildings or improvements on the above-described property, or on the real estate itself for services or materials furnished. This the _____ day of ______________ , 20______. Subcontractor’s Notice of Right to Claim a Lien Page 2 of 2 ______________________________Signature ______________________________ Type or Print Name Certificate of Delivery I, __________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to __________________________________, prime contractor, by: ( )Personal Service and receipt by prime contractor or his or her agent ( )Mailing a true and correct copy of same by certified U.S. mail, postage prepaid, return receipt requested to __________________________________. So certified this the _____ day of ______________, 20______. ________________________ Signature