CONSTRUCTION LIEN SERVICES OF MONTANA, INC.
CONSTRUCTION LIEN QUESTIONNAIRE - Printable Form
1. Print and Fill out this form
2. Payment for requested services by credit card or check.
3. Lien documentation prepared and documents sent to client for signature.
4. Signed lien documents returned to Construction Lien Services (by enclosed pre-addressed, stamped
envelope).
5. Your lien is sent for filing within 5 working days, and notice of the filing is sent to the property owner and all
interested parties.
Your Information
Company Name: ___________________________________________________
Type (LLC, Inc., Partnership, Individual, etc):_____________________________
Mailing Address:
City: _____________________________ State: ________________ Zip:________________
Phone: __________________________
Fax: ____________________________
Contact Person: ___________________
Contact Email: ________________________________
Project Type:
___ Residential
___ Commercial
Project Responsibilities:
(Check the term that identifies your role in the project)
____ General Contractor
____ Subcontractor Property Tenant
____ Sub-Subcontractor Prime Contractor
____ Supplier Contractor
____ Other
Who hired you:
____ Property Owner
____ Property Tenant
____ General Contractor
____ Subcontractor
____ Other
Company/Person who hired you: ___________________________________
Contact Person: _____________________________________
Mailing Address: ____________________________________
City: ____________________State:____________________ Zip: _________________
Property Information
Exact Address where you performed the Work:__________________________________
Address: ____________________________
City: __________________ State: _________________ Zip: ________________
County Where Work Performed: ________________________________
Legal Property Description:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If the legal property description is not available Construction Lien Services of Montana, ill research and obtain the legal
property description. An added charge for this service may be required.
Dollar amount of Lien / Claim: $ _________________________________
First Date Materials Provided or Labor Performed: _____/ ______/ 20___
Last Date Materials Provided or Labor Performed:
Payment:
Payment for services is required before the preparation and processing of your lien documents.
Payment for service(s) requested can be made online at constructionlienmt.com by clicking on the appropriate
payment button on the Order Form page.
Payment can also be made by credit card over the phone.
Payment can also be mailed by check.
Terms and Conditions apply