Notice of Intent to Lien

Notice of Intention to File Lien:

NOTICE SENT TO:

[_____]    PROPERTY OWNER (Name & Address)

 

 

 

 

[_____]    PRIME CONTRACTOR (Name & Address of Prime Contractor)

 

 

 

 

[_____]    HIRING PARTY (Name & Address of party who hired the CLAIMANT)

 

 

 

 

[_____]    LENDER (Name & Address of Lender on Projec)

 

 

 

 

CLAIMANT (Name & Address of Party Sending Notice)

 

 

 

 

Services, labor, materials, equipment and/or work provided by the Lienor (“SERVICES”):

 

 

 

 

SERVICES were supplied in the i mprovement and/or construction of real property described as follows (the “PROPERTY”):

 

 

 

 

 

AMOUNT OF CLAIM:

$

 

 

THIS IS NOT A LIEN. THIS NOTICE is sent pursuant to the requirements of the Illinois Mechanics Lien Act.

YOU ARE HEREBY NOTIFIED that the above - identified CLAIMANT has been employed by the above - identified HIRING PARTY to provide the materials and/or labor above - described as the SERVICES upon the property owned by the PROPERTY OWNER, as above - described and id entified as the PROPERTY.

The SERVICES are being provided to the HIRING PARTY pursuant to a contract between the HIRING PARTY and the PRIME CONTRACTOR, who is in contract with the PROPERTY OWNER. If the HIRING PARTY AND PRIME CONTRACTOR are one and the same in the above - table identifying said parties, then the SERVICES are provided to the HIRING PARTY pursuant to its contract with the PROPERTY OWNER.

YOU ARE FURTHER NOTIFIED that there is an amount due to the CLAIMANT for the sum above - identified as th e AMOUNT OF CLAIM. The CLAIMANT claims a lien against your interest in the above - identified PROPERTY and also against the funds due to the PRIME CONTRACTOR. Pursuant to the Illinois Mechanics Lien Act, the CLAIMANT will file its Claim of Mechanics Lien unless payment is made unto it within the next ten (10) days.

State of

County of

On the date indicated to the right of this verification, ____________________ , Agent for CLAIMANT, and represented by ___ __________________________, personally came and appeared before me, and voluntarily executed this instrument in the agent ’ s stated capacity. The deponent says that s/he has read the foregoing Notice of Intent to File Mechanics Lien and knows the content s thereof, that as the appointed agent for the CLAIMANT the deponent has been provided the information indicated in this notice, and that the same is true upon the deponent ’ s information, knowledge and belief.

Notary Public

Signed this ____ day

of _________________, 20____ .

Agent for CLAIMANT

Signed by:

Title:

PROOF OF SERVICE AFFIDAVIT

I, __________________________, being duly sworn, deposes and says that I am over the age of 18 years old, that this affidavit is made upon my own personal knowledge, and that on the _____ day of _____________, 20____, I served the attached Statement of Account and Claim of Lien, and the attached Notice of Demand for Attorneys Fees, to the following parties at these stated addresses:

[_____]    PROPERTY OWNER

 

 

 

 

[_____]    Hiring Party

 

 

 

 

[_____]    Prime Contractor

 

 

 

 

[_____]    Lender

 

 

 

 

I served the attached document:

[_____]   By personally deli vering the notice to the identified parties;

[_____]   By First Class Certified or Registered Mail service, return receipt requested, postage prepaid, and with delivery restricted to the addressee.

State of

County of

Sworn to and subscribed before me, undersigned Notary Public, on the date inscribed to the right of this verification.

Notary Public

Signed this ____ day

of _________________, 20____ .

Agent for Lienor

Signed by:

Title:

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