File a Speedy Lien

Servicing New York, New Jersey, Connecticut and Pennsylvania

File a Mechanic's Lien with Speedy Lien

We request Speedy Lien, Inc. to prepare, sign and file a Mechanic’s Lien on our behalf as our agent. The information we provided is true and correct and we assume responsibility in the event information provided is incorrect. The filing fee is $475.00 (** with the exception of jobsites located in Nassau County/ Suffolk County/ State of Connecticut / State of Pennsylvania – the filing fee is $575.00 **).


(A post office box is NOT a sufficient address.)
(If we have any questions, who should we speak with?)


(What type of work was performed? If you supplied materials only, please write "NONE.")
(Did you supply materials? If you performed labor only, please write "NONE.")
(First date of signed contract / agreement or first date services were rendered on site)
(Exact Last Date of Services / Last Date of Delivery or Sale)
(Grand total of services rendered to date)

(Including retainage, change orders / extras, etc.)
(Who hired you?)
13 - General Contractor (If you were contracted directly by the General Contractor, please list their info for #12, disregard #13)
**There is a $50 Fee to Serve the General Contractor**
(If you were contracted directly by the General Contractor, please list their info for #12, disregard #13.)
14. Public Improvement - If a Public Improvement / Municipal Project (provide agency & contract #)

I/We agree to pay Speedy Lien, Inc. $475.00 (or $575.00 for jobsites located in Nassau County, Suffolk County, the State of Connecticut or the State of Pennsylvania) for their services and agree that services commence upon their receipt of this document. I/We are aware that Speedy Lien, Inc. is liable to the extent of the cost of the Mechanic’s Lien in the event of error. I/We are aware that the information contained in this document is the proprietary right of Speedy Lien, Inc. and will not be sent to any other entity other than Speedy Lien, Inc. I/We are aware than any unauthorized use of this document is a violation of law and Speedy Lien, Inc. will prosecute to the fullest extent of the law.


Paying by Credit or Debit Card, Complete the Following:

Paying By Check:

Check Payable to: Speedy Lien, Inc.

Print Intake Sheet, Prepare Check and Email
Or Fax: 516-679-6703