Notice of Claim of Lien | Vessel Documentation

NOTICE OF CLAIM OF LIEN (NCL)

These are general instructions highlighting the minimum filing and recording requirements. There is no OMB approved Notice of Claim of Lien form. Guidance on the elements and validity of a maritime lien should be obtained through private legal counsel in accordance with 46 CFR Part 67.250.nDISCLAIMER: NEITHER THE FILING OF A NOTICE OF CLAIM OF LIEN NOR THE ACCEPTANCE BY THE COAST GUARD OF SUCH A NOTICE IS A GUARANTEE THAT THE CLAIM IS VALID OR ENFORCEABLE.

VESSEL NAME
OFFICIAL NUMBER*
HULL ID NUMBER (HID) *IF APPLICABLE
NAME OF CLAIMANT (INDIVIDUALS/ENTITIES WHO ARE OWED MONEY)
First Last
ADDRESS OF CLAIMANT (INDIVIDUALS/ENTITIES WHO ARE OWED MONEY)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
AMOUNT OF CLAIM
DATE OF CLAIM
MM slash DD slash YYYY
NATURE OF LIEN CLAIMED (DESCRIBE)
ACKNOWLEDGMENT
- THE INFORMATION STATED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF.
AUTHORIZED SIGNATURE*

SIGNATURE (TYPE FULL NAME)
Signature*
CAPACITY (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)

CAPACITY (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)
NOTICE OF CLAIM OF LIEN( NCL)
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BILLING ADDRESS*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name*
First Last
Email*
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Phone*
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Notice of Claim of Lien (NCL)

NOTICE OF CLAIM OF LIEN (NCL)