Claim Of Mechanics Lien Form
Download a blank fillable Claim Of Mechanics Lien Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Claim Of Mechanics Lien Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3Recording requested by (name):
____________________________________________
When recorded, mail to (name and address):
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Recorder’s Use Only
CLAIM OF
Declaration of Exemption From Gov’t Code § 27388.1 Fee
MECHANICS LIEN
Transfer is exempt from fee per GC § 27388.1(a)(2):
recorded concurrently “in connection with” transfer subject to DTT
recorded concurrently “in connection with” a transfer of
(Cal. Civ. Code § 8416)
residential dwelling to an owner-occupier
Transfer is exempt from fee per GC 27388.1(a)(1):
Fee cap of $225.00 reached
Not related to real property
1.
_________________________________________________ (“claimant”) claims a mechanics lien for the labor
or services or equipment or materials described in paragraph 2, furnished for a work of improvement on that certain real
property located in the County of ____________________________, State of California, and more particularly described
as (address and/or sufficient description):______________________________________________________________
_______________________________________________________________________________________________
2.
After deducting all just credits and offsets, the sum of _______________________, together with interest at the
rate of ________ per annum from __________________ (date when balance became due), is due claimant for the
following labor, materials, services, or equipment: _______________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
3.
Claimant furnished the labor or services or equipment or materials, at the request of _____________________
_________________________________________________________________ (employer, person, or entity to whom
labor, materials, services, or equipment were furnished).
4.
The name and address of the owner or reputed owner of the real property is/are: _______________________
_______________________________________________________________________________________________
5.
Claimant's address is: ______________________________________________________________________.
Dated ____________________
_______________________________________
(Signature)
VERIFICATION
I, _______________________________________, am the: __________________________________ (“owner,”
“president,” “authorized agent,” “partner,” etc.) of claimant on the foregoing claim of mechanics lien, and am authorized to
make this verification for and on its behalf. I have read the foregoing claim of mechanics lien and know the contents of the
claim of mechanics lien to be true of my own knowledge.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Dated ____________________
_______________________________________
(Signature)
1/24/18
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal