Notice of Nonpayment Form
(Consult an attorney before using this form or information)

NOTICE OF NONPAYMENT

Date

To (name of contractor and address)

(name of surety and address)

The undersigned notifies you that he or she has furnished (describe labor, services, or materials) for the improvement of the real property identified as (property description) . The amount now due and unpaid is $_____.

(signature and address of lienor)