AFFIDAVIT OF THE LIENOR
STATE OF NEW YORK )
ss:
COUNTY OF SUFFOLK)
The undersigned, ___________________, being first duly sworn, hereby deposes
(Lienor’s Name)
and states:
I, ____________________, am the lienor in ________________, mechanic’s lien
(Lienor’s Name) (Case Name)
number ______________. I do hereby certify that:
(1) The mechanic’s lien was filed with the Clerk of Suffolk County, New York, on
______________;
(Date)
(2) I received notice on __________ that _____________________, the lienee,
(Date) (Lienee’s Name)
deposited money into court to discharge the mechanic’s lien on ___________;
(Date)
(3) I have not begun an action to foreclose this lien in any county in the State of
New York, within one year from the time of filing the notice of lien; and
(4) I have not secured a court order to continue the lien, within one year from the
time of filing the notice of lien.
_____________________________
Lienor’s Signature
Subscribed and sworn to before me
this _____ day of _________, 20__
_____________________________
Notary Public
