Mechanics Lien Intake Form

  • Home
  • Mechanics Lien Intake Form






Section I.

Client Information









Type of Business (select one):
State of Incorporation/Organization: Other:

If subcontractor/material supplier:







Section II.

Work Performed


Person/Company that hired Contractor is the:









Property Owner Information (if different than above)






Dollar Amount of Claim





Was pre-lien notice given to the property owner before beginning work?

Please attach copies of information that you think may be helpful including contracts, prelien notices, invoices,
receipts and communications relating to the project.


Section III.

Acknowledgments

We will not be responsible for processing lien filings later than 90 days after your last date of work.

BY TYPING NAME BELOW, YOU ACCEPT RESPONSIBILITY FOR THE INFORMATION PROVIDED AS BEING COMPLETE AND CORRECT. ON BEHALF OF THE LIEN CLAIMANT, I AUTHORIZE MINNESOTA CONSTRUCTION LAW SERVICES PLLC TO PREPARE, SERVE, AND RECORD A LIEN STATEMENT IN ACCORDANCE WITH THE FOREGOING FOR A FEE, PLUS ANY FILING FEES, OUT OF POCKET EXPENSES, AND COST OF SERVICE ON NECESSARY PARTIES.