Affidavit Of Service Of Mechanics Lien Statement By Personal Service Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Affidavit Of Service Of Mechanics Lien Statement By Personal Service Form. This is a Minnesota form and can be use in Department Of Commerce Statewide.
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Tags: Affidavit Of Service Of Mechanics Lien Statement By Personal Service, 40.4.2, Minnesota Statewide, Department Of Commerce
(Top 3 inches reserved for recording data)
AFFIDAVIT OF SERVICE OF MECHANIC’S LIEN STATEMENT
by certified mail
Minnesota Uniform Conveyancing Blanks
Form 40.4.2 (2011)
State of Minnesota, County of:
I,
being duly sworn on oath say as follows:
on
I served a true and correct copy of the attached Mechanic’s Lien Statement by certified mail
(month/day/year)
upon
,
(insert name of person served)
who, according to the best information then had, was
(check appropriate boxes)
the Owner;
the Owner’s authorized agent; and/or
the person who authorized the Work.
at
,
(insert address to which the Statement was mailed)
which was the last known address of said person.
(signature)
Page 1 of 2
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Minnesota Uniform Conveyancing Blanks Form 40.4.2
Page 2 of 2
Signed and sworn to before me on
, by
(month/day/year)
(insert name of person making statement)
.
(Stamp)
(signature of notarial officer)
Title (and Rank):
My commission expires:
(month/day/year)
THIS INSTRUMENT WAS DRAFTED BY:
(insert name and address)
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