Section 49 By Subcontractor/Supplier

• Library: Mechanics Liens 2015 Forms

1. (§49) By Subcontractor/Supplier

In the Circuit Court of ___________ County

Statement of Mechanic’s Lien

[By Subcontractor/Supplier]

[Lien Claimant] ___________, a ____________ corporation (hereinafter “lien claimant”), with its principal place of business located at ____________ and with a view toward availing itself of the statutes relating to mechanic’s liens, files the account set out on the attached Exhibit A, made a part of this statement for all purposes, for work and labor performed and materials furnished by it under one contract with ____________, which was a subcontractor to ____________, the general contractor, who entered into a contract with ____________, the owner, for real estate located at [address] ____________, in ____________ County, Missouri. A true and correct legal description of the property (hereinafter “subject real estate”) is:

[lengthy descriptions may be attached

by separately identified exhibit]

The fee simple title to the above premises and to the improvements on it is presently held by ____________. The fee simple title to the above premises was held by ____________ on the date and dates that lien claimant’s work, labor, materials, fixtures, and machinery were contracted for and provided or furnished for the subject real estate.

The account described on the attached Exhibit A is being filed with this statement that it may constitute a lien on the subject real estate. The last date work and labor were performed on the subject real estate by the lien claimant was the ____ day of...