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PLEASE FILL OUT THE FIELDS BELOW

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  • Example: $2358, through 3/14/16
  • Lien and Bond Claims*

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Please provide the customer's statement of account and contract so that we can more accurately calculate the lien deadline. We can also use the statement of account to determine the last date of substantial performance.
  • Collection

  • Other

  • This field is for validation purposes and should be left unchanged.

*Please provide at least 10 business day lead-time for lien claim referrals within the State of Washington and 15 business days for claims in other states. Note that many recording offices have backlogs and may not record documents for many days following receipt. Levy | von Beck | Comstock | P.S. cannot assume responsibility for ensuring recordation by a specific date. 

 

DISCLAIMER: Use of this form indicates review and acceptance of the Lien Perfection Services Agreement.