After Recording, mail to:
[Name and address]

NOTICE OF CLAIM OF LIEN

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:

[insert]

4. That the name[s] of the person[s] by whom claimant
was employed or to whom claimant furnished the materials is
[are]

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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