ROHILLCO BUSINESS SERVICES, LLC
Construction Lien Claim
Request Form |
| |
Your
Company Name : |
|
Contact : |
|
Telephone : |
|
Fax : |
|
File
A Lien Against (The contractor/person that hired you)? : |
|
Job
Site Address : |
|
Customer
Telephone : |
|
Customer
Contact : |
|
| |
| Is
this project residential or commercial?
|
| Did
you supply labor, materials or both?
|
| When
did you commence supply or service?
|
| What
was you last day of supply or service?
|
| What
was the total amount of the contract/job?
Labor :
Material :
|
| Payments
received?
Principal
balance owing?
|
| Finance charge
owing?
Through what date?
|
| Was
a notice of right to lien sent (include copy)?
|
Full
name and title of document signer (must be knowledgeable of
circumstances of the debt):
|
|
| RoHillCo
Business Solutions, LLC |
5 Mount Jefferson Terrace
Lake Oswego, OR 97035
503-636-0495 Fax 503-636-0848 |
|
|
|
|
