| NORTH CAROLINA |
___________
COUNTY
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NOTICE OF SUBCONTRACT |
| 1. | Name and address of the Contractor: | |
| 2. | General description of the real property where the labor was performed or the material was furnished (street address, tax map lot and block number, reference to recorded instrument, or any description that reasonably identifies the real property): | |
| 3. |
(i) General description of the Subcontractor's contract, including the names of the parties thereto:
(ii) General description of the labor and material performed and furnished thereunder: |
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| 4. | Request is hereby made by the undersigned subcontractor that he be notified in writing by the contractor of, and within 5 days following, each subsequent payment by the contractor to the first tier subcontractor for labor performed or material furnished at the improved real property within the above descriptions of such in paragraph 2 and subparagraph 3(ii), respectively, the date payment was made and the period for which payment is made. |
| Dated: ______________________. |
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SUBCONTRACTOR
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