| NORTH CAROLINA |
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COUNTY
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NOTICE OF CLAIM OF LIEN BY SECOND TIER SUBCONTRACTOR |
| TO: | 1. | OWNER: | |
| 2. | GENERAL CONTRACTOR: | ||
| 3. | FIRST TIER SUBCONTRACTOR AGAINST OR THROUGH WHOM SUBROGATION IS CLAIMED: |
| General description of real property where labor performed or material furnished: | |
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General description of the undersigned Lien Claimant's contract, including the names and addresses of the parties thereto:
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The amount of lien claimed pursuant to the above-described contract:
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| The undersigned Lien Claimant gives this Notice of Claim of Lien pursuant to North Carolina law and claims all rights of subrogation to which he is entitled under Part 2 of Article 2 of Chapter 44A of the General Statutes of North Carolina. | |
| Dated: ______________________. |
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____________________________
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LIEN CLAIMANT
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By: ____________________________
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ADDRESS
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TELEPHONE
NUMBER
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