Attorney Lien Form

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Attorney Lien
Effective Date
____/____/______
The Claimant
[Legal Name], AKA (The Claimant)
Located at
[Address]
[City], [State] [Zip Code]
Notice is hereby given that an Attorney Lien is being filed against
The Client
[Legal Name], AKA (The Client)
Located at
[Address]
[City], [State] [Zip Code]
General Description of Property:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
The sum of $__________ is the claim amount together with interest thereon at the rate of
________ percent per annum from ____/____/______, is due the above mentioned claimant
(after deducting all just credits and offsets) for the following legal work furnished by the
claimant:
Description of the work:
_____________________________________________________________________________
_____________________________________________________________________________
__________________________________________________________
Date____________
Signature of Claimant
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