Subcontractors Claim For Lien {201}

x-none)x-none)x-noneNOTICE AND CLAIM FOR LIEN IN AMOUNT OF x-noneThe claimant x-none,x-noneofx-noneCounty of LaSalle, State of Illinois, hereby filex-nonea noticex-noneand Claim for Lien againstx-noneContractorx-noneofx-noneCounty ofx-noneState of Illinois,x-noneandx-noneowner ofx-noneCounty of x-noneState of x-noneThat on the x-noneday ofx-none, said last named personx-nonethe ownerx-noneof the following described land x-nonein the County of LaSalle, State of Illinois to Wit: x-nonePermanent Index Numberx-noneAddressx-nonehx-noneContractorx-nonefor the improvement thereof.x-noneThat on the x-noneday ofx-nonesaid Contractorx-nonemade a subcontract with the Claimant x-noneto (1) x-nonefor and in said improvement, and that, on the x-noneday ofx-nonethe Claimantx-nonecompleted thereunder (2)x-nonePage 1 of 2 Pages x-none20 x-none(over) x-noneSUBCONTRACTORS CLAIM FOR LIEN NO. 201 x-none20 x-nonew x-noneSTATE OF ILLINOIS x-noneCOUNTY OF LA SALLE x-nonevs. x-noneClaimant x-noneDefendant x-noneSTATE OF ILLINOIS x-noneCOUNTY OF LA SALLE x-noneSS American LegalNet, Inc. www.FormsWorkFlow.com x-noneSUBCONTRACTOR'S CLAIM FOR LIENx-none*That, at the special instance and request of said Contractorx-none, the Claimantx-nonefurnished extra and additional x-nonematerials at the extra and additional labor on said premises of the value of $ x-noneas fully set forth in an accountx-nonethereof herewith filed and made part of, marked Exhibitx-none, and did complete the same on the x-noneday ofx-none.x-noneThat neither said owner, nor agent, architect or superintendent can, upon diligence, be found in said County so as tox-noneserve upon either of them personally a notice hereof in accordance with the statute in such cases made and provided.x-noneThat said Contractorx-noneentitled to credits on account thereof as follows:x-noneleaving due, unpaid and owing to the Claimantx-none, after allowing all credits, the sum of $x-nonefor whichx-nonewith interest, the Claimant x-noneclaim x-nonea lien on said land and improvements, against said Contractorx-noneandx-noneownerx-none.x-noneSignature x-none(1) State what the claimant x-nonewas to do (2) "all required said contract to be done," or "delivery of materials to the valuex-noneof $x-none," or "labor to the value of $x-none," as fully set forth in anx-noneaccount thereof, herewith filed and made part hereof, marked Exhibit x-none*if extras, fill out: in no extras, strike out. x-noneThis instrument prepared by:x-noneNamex-noneAddressx-noneSTATE OF ILLINOISx-none)x-noneCOUNTY OF LASALLEx-none)x-noneThe affiantx-nonebeing first duly sworn on oath deposes and says, that he isx-noneof the Claimantx-none: that he has read the foregoing notice and Claim for Lien, knows the contents thereof, and that all thex-nonestatements therein contained are true.x-noneSubscribed and sworn before me thisx-noneday ofx-none, A.D. 20 x-nonePAGE 2 OF 2 PAGES x-none, A.D. 20 x-none(If a firm, sign firm name) x-noneSS x-noneNotary Public American LegalNet, Inc. www.FormsWorkFlow.com