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Fillable Printable Notice of Mechanic's Lien Under Lien Law

Fillable Printable Notice of Mechanic's Lien Under Lien Law

Notice of Mechanic's Lien Under Lien Law

Notice of Mechanic's Lien Under Lien Law

NOTICE OFMECHANIC'S LIEN UNDER LIEN LAW
To the Clerk of the County of       and all others whom it may concern:
PLEASETAKENOTICE,that     ,aslienorhasandclaimsalienontherealproperty
hereinafter described as follows:
(1)Thenamesandresidencesofthelienorare     ,      NewYork     ,beinga
corporationcomposedofshareholders,whosebusinessaddressisat     ,     ,NewYork
     , and whose principal place of business is at      , New York      .
If a partnership, the names and addresses of the partners are      .
The name and address of lienor’s attorney if applicable is      .
(2) Theowneroftherealpropertyis     andtheinterestoftheowner, uponinformationand
belief of the lienor, is fee simple.
(3) The name of the person by whom the lienor was employed is      
(4)Thenameofthepersontowhomthelienorfurnishedoristofurnishmaterialorforwhom
the lienor performed or is to perform professional services is      .
(5) The name of the person with whom the contract was made is      .
(6) The labor performed and material furnished was      .
(7) The materials actually manufactured for but not delivered to the real property are      .
(8) The agreed price and value of the labor performed and the material furnished is
$     .
Theagreedpriceandvalueofthematerialactuallymanufacturedbutnotdeliveredtothereal
property is $     .
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     
 
     
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     $     %     $&     $'     (
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+,     
&-,......................................
     
VERIFICATION - CORPORATION
%/012304-156, ss.:
#173-12     
     $$          $$
$
8$9
therein stated to be alleged upon information and belief, and that as to those matters deponent believes it
to be true. The reason why this verification is made by deponent is that deponent is an officer, to wit, the
     of     ,whichisadomesticcorporation,anddeponentisfamiliarwiththefactsand
circumstances herein.
Thesourceofdeponent’sinformationandthegroundsofdeponent’sbeliefastoallmatters
therein stated upon deponent’s knowledge are as follows: books and records of the corporation.
___________________________________
     
Sworn to before me this      
day of      
______________________________
Notary Public
VERIFICATION - INDIVIDUAL
STATE OF NEW YORK, ss.:
COUNTY OF      
      being duly sworn, says that deponent is (one of the co-partnership named in the within notice of
lien and) the lienor(s) mentioned in the foregoing notice of lien; that deponent has read the said notice
and knows the contents thereof, and that the same is true to deponent’s own knowledge, except as to the
matters therein stated to be alleged on information and belief, and that as to those matters deponent
believes it to be true.
Sworn to before me on this      
day of      
______________________________
Notary Public
Affidavit of Service of Notice of Mechanic’s Lien on Owner,Attorney or Agent
STATE OF NEW YORK, ss.:
COUNTY OF      
The undersigned, being duly sworn, deposes and says that deponent is over 18 years of age and
on       served the within Notice of Mechanic’s Lien
on      
the owner, agent or attorney      
at      
by delivering a true copy to said owner personally. Deponent knew the person so served to be the
owner.
as the owner could not be found, by delivering a true copy to the agent attorney of the owner.
byleavingitatthelastknownplaceofresidenceoftheownerinthecityortowninwhichthe
real property or some part thereof is situated, with a person of suitable age and discretion.
bydepositingatruecopyofsame,enclosedinacertifiedregisteredmail,postpaid,properly
addressedwrapper,inanofficialdepositoryoftheUnitedStatesPostalServiceinNewYork
State.
astheowner hasno lastknownplaceofresidenceinthecityortown inwhich therealproperty
or some part thereof is situated, or the owner could not be found, and has no agent or attorney, by
affixinga truecopythereofconspicuously onsuchproperty, atm. (betweenthehoursof nine
o’clock in the forenoon and four o’clock in the afternoon).
astheownerisacorporation,bypersonallydeliveringatruecopyandleavingitwiththe
president,vice-president,secretary,clerk,cashier,treasurer,director,managingagentofthe
corporation.
astheownerisacorporation,andnoofficerofthecorporationcouldbefoundwithinthestate,
byaffixingatruecopyconspicuouslyonsuchpropertyatm.(betweenthehoursofnine
o’clock in the forenoon and four o’clock in the afternoon).
astheownerisacorporation,bydepositingatruecopyofsame,enclosedinacertified
registeredmail,postpaid,properlyaddressedwrapper,inanofficialdepositoryoftheUnited
States Postal Service in New York State.
____________________________________
     
Sworn to before me on this      
day of      ,      
________________________
NOTARY PUBLIC
NOTE: The Notice of Mechanic's Lien must be served 5 days before or no later then 30 days after filing.
Adavit of Service by Certied Mail
STATE OF NEW YORK, ss.:
COUNTY OF      
$$)

     3'     
contractor subcontractor assignee legal representative
     
$$$
$:7%;%
3-%(
....................................
%     
     $     
......................
31/5-;7&'<#
Note:/!
3=8'(;$''%>?$
##81:!@3=8'
(
Note:%3=8'
!3=8'(2##!@
3=8'(%''A>(
Mechanic’s LienNotice of Lien
#,     
/,     
against
1,     
#,     
/,     
2,     
;,     
&,     ',     
/',     
;1:/
3,
     
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