File a Bond Discharge of Mechanic's Lien

We request Speedy Lien Inc. prepare and file a Mechanic’s Lien Discharge Bond on our behalf. The information we provided is true and correct. We assume responsibility in the event information we provided is incorrect. The total filing fee is $785.00 ($575 Representation Fee + $210 Index Filing Fee.)

YOUR CONTACT INFORMATION

1 - Petitioner's Exact Name (or Entity): *

2 - Our Address *

2a - City *

2b - State *

2c - Zip *

2d - Floor/Suite #

3 - Telephone *

3a - Email Address *

4 - Officer's Name (Member of the Entity) *

4a - Officer's Title

(Member, President, Corporate Secretary, Etc.)

5 - What is your role in the situation?

(Property owner, general contractor, sub-contractor, etc.)

JOBSITE INFORMATION

6 - Address of Property Liened *

6a - City *

6b - State *

7 - Party Who Filed the Lien:

7a - Their Address: *

7b - City *

7c -State *

7d - Zip *

8 - Date Lien was Filed *

9 - Amount of Lien: *

10 - Do you have a copy of the Lien?

YES

(A copy of the Lien is required for filing.)

11 - Have you obtained the Surety Bond?

YES

(If not, we can refer you to a Surety Company)

I/We agree to pay Speedy Lien, Inc. $575 Representation Fee for their services in addition to the $210 Index Filing Fee. Total Filing Cost is $785.00. I/We agree that services commence upon their receipt of this document. I/We are aware that Speedy Lien, Inc. is a Filing Agent and not a party to this action. I/We agree Speedy Lien, Inc. is not a law firm and our employees are not acting as your attorney. This Limited Power of Attorney is valid for the filing of the Discharging of Mechanic’s Lien Bond; upon completion of the filing, this Power of Attorney is no longer valid.

Type Your Name as Signature *

Date *

PAYMENT INSTRUCTIONS

Paying by Credit or Debit Card, Complete the Following:

Cardholder's Name *

Billing Address *

Zip Code *

Card Number *

Exp Month *

Exp Year *

I/We authorize Speedy Lien, Inc. to charge my/our credit card. *

Yes

If Paying By Check:

Check Payable to: Speedy Lien, Inc. Print Satisfaction Request, Prepare Check and Email DN@SpeedyLienInc.com

Or Fax: 516-679-6703

File a Bond Discharge of Mechanic’s Lien