Notice of Claim of Lien

After Recording, mail to:
(Name and address)


The undersigned claimant hereby claims a mechanic`s
lien under section_______of the Civil Code of the State of
_________ and hereby declares the following:

1. That a statement of claimant`s demand, after
deducting all just credits and offsets, in the sum of
$ .

2. That the name of the owner(s), or reputed owner(s)
of the property is (are):

3. A general statement of the kind of work done or
materials furnished by claimant, or both is:

4. That the name(s) of the person(s) by whom claimant
was employed or to whom claimant furnished the materials is

5. A description of the property sought to be charged
with the lien is: (enter full legal description here).

DATED: ________________

(Signature of Claimant)

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