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Claim of Lien Form
Secure your legal right to payment for labor or materials by filing this Claim of Lien Form Template.
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CLAIM OF LIEN FORM TEMPLATE
This Claim of Lien (“Claim”) is filed on [Date], by:
Claimant: [Full Legal Name / Business Name]
Address: [Claimant’s Address]
Phone: [Phone Number]
Email: [Email Address]
Against Property Owned by: [Owner’s Full Legal Name]
Address: [Owner’s Address]
Property Description: [Full Legal Description of Property, including address, lot, block, subdivision, county, and state]
1. Statement of Claim
The Claimant performed labor, furnished materials, or provided services for the improvement of the property described above under contract with [Name of Contractor/Subcontractor/Owner].
2. Amount Owed
The total amount due and unpaid for such labor, materials, or services is $[Amount]. This amount became due on [Date].
3. Nature of Work
The work performed or materials furnished included:
[Brief description of work or materials provided, e.g., roofing, plumbing, electrical supplies, construction materials].
4. Dates of Work
The work and/or furnishing of materials commenced on [Start Date] and was completed or last provided on [End Date].
5. Legal Right to Lien
The Claimant asserts a lien against the property pursuant to [cite relevant state statute or lien law], securing payment of the unpaid balance for the improvements described herein.
6. Verification
I hereby verify under oath that the foregoing statement is true and correct to the best of my knowledge and belief.
Claimant Signature: ___________________________ Date: ___________
Printed Name: ________________________________
Notary Acknowledgment:
State of [State]
County of [County]
On this ____ day of ________, 20, before me, the undersigned Notary Public, personally appeared [Claimant’s Name], personally known to me or proved by satisfactory evidence to be the individual who executed this instrument, and acknowledged that they executed it for the purposes stated herein.
Notary Public Signature: _______________________
My Commission Expires: ___________
Details
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Claim of Lien Form
CLAIM OF LIEN FORM FAQ
What is a Claim of Lien Form?
A Claim of Lien Form is a legal document filed by a contractor, subcontractor, or supplier to secure payment for labor, services, or materials provided to improve a property. It creates a legal interest in the property until the debt is satisfied.
Why is a Claim of Lien Form important?
It ensures that property owners and lenders are aware of unpaid debts tied to construction or improvements. Filing a lien gives the claimant leverage to demand payment, as the lien can cloud the property title and prevent sale or refinancing until resolved.
When should you use a Claim of Lien Form?
You should use this form when payment for construction-related services or materials has not been received after completion of work, and before the statutory deadline for filing a lien in your jurisdiction expires.
What should a Claim of Lien Form include?
It should clearly identify the claimant, property owner, property description, nature of work, amount owed, dates of work, and include a verification under oath. Filing must comply with state-specific lien laws.
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