NOTICE TO CONTRACTOR

TO:

(Name and address of Contractor)

The undersigned notifies you that he has furnished or is furnishing [describe services or materials]

for the improvement of the real property identified as [legal description]

owned by [owner's name and address]

under an order given by

and that the undersigned will look to the contractor's bond for protection on the work and that

(insert name and address) is designated to receive any request for written statement of account.

Lienor

By:

Print Name:

Print Title:

Address: