__________________________________________________________________
__________________________________________________________________
_________________________________________________________________.
5.A description of the labor, services, or materials being provided and, if known, the contract price or anticipated value of the labor, services, or materials to be provided or the amount claimed to be due, if any, is:
__________________________________________________________________
__________________________________________________________________
_________________________________________________________________.
6.This Notice is filed within 30 days from the filing of the Notice of Commencement or 30 days following the first delivery of labor, services, or materials to the property, whichever is later.
WITNESS my signature on this the _____ day of _________________, 20_____.
____________________________________
Signature
Print Name: _________________________
AFFIDAVIT OF SERVICE
State of ________________
County of ____________________
I, ________________________________, hereby certify that I have this date sent a true and
correct copy of this ______________________________________ by
personal service or by
U.S. mail, return receipt requested, in accordance with law, to the owner or the agent of the owner and the contractor at the addresses set forth in the Notice of Commencement, which the names and addresses are as follows:
__________________________________
__________________________________
__________________________________
__________________________________
DATED this the ______ day of __________________, 20______.
_____________________________
Signature
_____________________________