NOTICE OF INTENTION TO FILE A MECHANIC'S LIEN

TO:  [name of owner]
     [address]

Notice is hereby given that the undersigned,   [name]
intends to file a mechanic's lien for     [amount]  Dollars
($      ), on real property owned by you and commonly known
as     [street address]     .  The legal for said property
is as follows:

The filing of said lien, pursuant to [cite statute]   , is
for the purpose of securing payment of amounts due for
[services]     performed by the undersigned within the last
[number] days, in accordance with the [written or oral]
agreement entered into on     [date]    between you and the
undersigned.
Date________________             __________________________

                                         [Signature]