NOTICE OF IDENTIFICATION
M.G.L. c. 254 §4
Notice is hereby given to _________________, as contractor, that ________________,
as subcontractor/vendor, has entered into a written contract with _________________ to furnish
labor or materials, or labor and materials, or rental equipment, appliances or tools to a certain
construction project located at ________________ (Street Address), ____________________
(Town or City), Massachusetts. The amount or estimated amount of said contract is
$__________. (No amount need be stated for contracts for the rental of equipment, appliances or tools).
COMMONWEALTH OF MASSACHUSETTS
Then personally appeared the above named ______________________ before me who after being duly sworn did acknowledge that his/her/ signature on the foregoing instrument is his/her free act and deed and that he/she is authorized to execute this document on behalf of the above-referenced Subcontractor or Vendor.