Washington Revised Code Title 60. Liens § 60.24.075. Claims--Contents--Form

․․․․․․ Claimant, vs․․․․․․

    Notice is hereby given that ․․․․․․ of ․․․․․․ county, state of Washington, claims a lien upon a ․․․․․․ of ․․․․․․, being about ․․․․․․ in quantity, which were cut or manufactured in ․․․․․․ county, state of Washington, are marked thus ․․․․․․, and are now lying in ․․․․․․․․․․, for labor performed upon and assistance rendered in ․․․․․․ said ․․․․․․; that the name of the owner or reputed owner is ․․․․․․; that ․․․․․․ employed said ․․․․․․ to perform such labor and render such assistance upon the following terms and conditions, to wit:

    The said ․․․․․․ agreed to pay the said ․․․․․․ for such labor and assistance ․․․․․․; that said contract has been faithfully performed and fully complied with on the part of said ․․․․․․, who performed labor upon and assisted in ․․․․․․ said ․․․․․․ for the period of ․․․․․․; that said labor and assistance were so performed and rendered upon said ......between the ․․․․ day of ․․․․․․ and the ․․․․ day of ․․․․․․; and the rendition of said service was closed on the ․․․․ day of ․․․․․․, and sixty days have not elapsed since that time; that the amount of claimant's demand for said service is ․․․․․․; that no part thereof has been paid except ․․․․․․, and there is now due and remaining unpaid thereon, after deducting all just credits and offsets, the sum of ․․․․․․, in which amount he or she claims a lien upon said ․․․․․․. The said ․․․․․․ also claims a lien on all said ․․․․․․ now owned by said ․․․․․․ of said county to secure payment for the work and labor performed in obtaining or securing the said logs, spars, piles, or other timber, lumber, or shingles herein described.

State of Washington, county of ․․․․․․ ss.

    ․․․․․․ being first duly sworn, on oath says that he or she is ․․․․․․ named in the foregoing claim, has heard the same read, knows the contents thereof, and believes the same to be true.

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    Subscribed and sworn to before me this ․․․․ day of ․․․․

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