W.S. § 29-10-102. Form for notice of intention to file lien
[Note to lien claimant: This form, if filled out correctly and sent within the time periods specified in W.S. 29-2-107 constitutes prima facie evidence that you have provided the contents of the notice required by W.S. 29-2-107(a). If you have any questions regarding how to fill out this form or whether it has been filled out properly, you should consult an attorney.]
CERTIFIED MAIL, RETURN RECEIPT REQUESTED
Record owner or agent of owner (note: If there is more than one (1) owner, use a form for each owner)
Date: ___, 20___
Re: Notice of Intention to File Lien
You are hereby notified pursuant to W.S. 29-2-107 that __________ (hereinafter the “lien claimant”) intends to file a lien against your property. The amount of the lien claim is $_______________. This amount is due from ___________ (person/entity whose actions have caused a lien to be filed) pursuant to a contract with the lien claimant under which the lien claimant performed work or
supplied materials for the work.
If we are unable to resolve this matter within twenty (20) days from the date of this notice, the lien claimant intends to file the lien statement asserting a lien against your property.