INTENT TO LIEN (LETTER) REQUEST – Construction Notice Services, Inc.

Company Name:
Company Address:

Business Telephone:
Fax:
Email Address*:

Do you want an intent to lien sent to your customer?
Customer Name:

Customer Business Name:
Customer Address:

Property Owner's Name:
Property Owner’s Business Name (if applicable):
Property Owner's Address:

Amount owed as of last statement$:
Job Site Name and Location:

Date the preliminary notice was filed:
File number:

Special Requests: