After Recording, mail to:
[Name and address]

                     NOTICE OF CLAIM OF LIEN

     The undersigned claimant hereby claims a mechanic`s
lien under section_______of the Civil Code of the State of
_________ and hereby declares the following:

     1.  That a statement of claimant`s demand, after
deducting all just credits and offsets, in the sum of
$        .

     2.  That the name of the owner[s], or reputed owner[s]
of the property is [are]:

     3.  A general statement of the kind of work done or
materials furnished by