FORM 1

WRITTEN NOTICE OF LIEN UNDER SUBSECTION 1(1) OF THE ACT

Construction Act

●
Name of person having a
lien:

Address for
service:

Name of
payer:

Addres
s:

Name of person to whom person having a lien supplied services or

materials:

Addres
s:

Time within which services or materials were supplied:

t
o
(date supply commenced) (date of most recent supply)

Short description of services or materials that have been supplied:

Description of premises:

Contract price or subcontract price: $

Amount claimed as owing in respect of services or materials that have been $

supplied:

Date
:
(signature of person having a lien)

CA-1-E (2018/04)