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Begin by filling in your name as the affiant in the designated field. Ensure that you provide accurate personal information.
In the section regarding the Claimant, enter the name of the individual or entity that furnished materials or labor. This is crucial for establishing your claim.
Complete the legally described property section with accurate details about the location of the property involved in your claim.
Attach Exhibit 'A' which includes a detailed statement of account, specifying dates, amounts, and prices for materials or labor provided.
Fill in the principal sum due and interest rate, ensuring all financial figures are correct to avoid disputes.
If applicable, check the box indicating that this claim is made by a subcontractor and provide necessary certifications.
Finally, sign and date the form at the bottom before submitting it for notarization as required.
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