Scribd Logo
Upload

Welcome to Scribd!

  • 10 views

    Tennessee Notice of Lien Template

    Uploaded by

    memphismatt76
    A Lien For Work Done

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Tennessee Notice of Lien Template

    Uploaded by

    memphismatt76
    10 views3 pages
    A Lien For Work Done

    Original Title

    Tennessee-Notice-of-Lien-Template

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    A Lien For Work Done

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views3 pages

    Tennessee Notice of Lien Template

    Uploaded by

    memphismatt76
    A Lien For Work Done

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 3

    Instrument Prepared By

    And Recording Requested By

    Space above this line for recorder’s use only

    TENNESSEE NOTICE OF LIEN


    STATE OF TENNESSEE
    COUNTY OF _____________________

    ________________________ being first duly sworn, says that ________________________,


    the Lien Claimant, furnished certain material or performed certain work or labor in furtherance of
    improvements to the real property hereinafter described, in pursuance of a certain contract, with
    ________________________, [the owner, prime contractor, remote contractor, or other person,
    as the case may be]. The first of the work or labor was performed or the first of the material,
    services, equipment, or machinery was furnished on the ____________ day of
    ________________, ______ (year). The last of the work or labor was performed or the last of
    the material, services, equipment, or machinery was furnished on the ____________ day of
    ________________, ______ (year), and there is justly and truly due Lien Claimant therefor from
    ________________________, [the owner, prime contractor, remote contractor, or other person,
    as the case may be] over and above all legal setoffs, the sum of ____________ dollars, for
    which amount Lien Claimant claims a lien under T.C.A. §§ 66-11-101, et seq. on the real
    property, of which ________________________ is or was the owner, which is described as
    follows:

    Claimant Signature: ___________________________________ Date: __________________

    Claimant Printed Name: _________________________________

    Page 1 of 3
    NOTARY ACKNOWLEDGMENT

    State of __________________
    County of __________________

    The foregoing instrument was acknowledged before me this __________________, by the


    undersigned, _________________________, who is personally known to me or satisfactorily
    proven to me to be the person whose name is subscribed to the within instrument.

    _________________________________
    Notary Public
    My Commission Expires: __________________

    Page 2 of 3
    PROOF OF SERVICE

    I, _______________________________ (the “Server”), served a copy of the Mechanic’s Lien in


    the following manner:

    Owner or Purported Owner Name: _____________________________ (the “Recipient”)


    Address: _______________________________________________________________
    Date of Service: ________________ (mm/dd/yyyy) Time: _____ : _____ ☐ AM ☐ PM

    The Recipient received the documents by: (check one)

    ☐ - Mail. The Server sent the documents in the mail via: (check one)

    ☐ Standard Mail
    ☐ Certified Mail
    ☐ FedEx
    ☐ UPS
    ☐ Other: ______________________________________.

    ☐ - Direct Service. The Server handed the documents to a person identified as the
    Recipient.

    ☐ - Someone at the Residence/Workspace. The Server handed the documents to


    a person who identified as living/working at the residence/workspace and stated
    their name is: ______________________________________.

    ☐ - Left at the Residence/Workspace. The Server left the documents in the following
    area: ______________________________________.

    ☐ - Recipient Rejected Delivery. The Server delivered the documents to the Recipient
    in person and the Recipient did not accept delivery.

    ☐ - Other: ______________________________________.

    I declare under penalty of perjury under the laws located in this State that the foregoing is true
    and correct.

    Server’s Signature: _________________________________ Date: ______________

    Printed Name: ________________________

    Page 3 of 3

    You might also like

    pFad - Phonifier reborn

    Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

    Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


    Alternative Proxies:

    Alternative Proxy

    pFad Proxy

    pFad v3 Proxy

    pFad v4 Proxy