After Recording， mail to：

[Name and address]

NOTICE OF CLAIM OF LIEN

The undersigned claimant hereby claims a mechanic`s lien under section_______of the Civil Code of the State of

_________ and hereby declares the following：

1.  That a statement of claimant`s demand， after deducting all just credits and offsets， in the sum of $        .

2.  That the name of the owner[s]， or reputed owner[s] of the property is [are]：

3.  A general statement of the kind of work done or materials furnished by claimant， or both is：

[insert]

4.  That the name[s] of the person[s] by whom claimant was employed or to whom claimant furnished the materials is [are]

5.  A description of the property sought to be charged with the lien is：  [enter full legal description here].

DATED：  ________________

_______________________ [Signature of Claimant]