L I E N S E A R C H F O R M

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L I E N Description & serial number of item to be checked:

S E A R C H

F O R M

Serial #

DEBTOR NAME ENQUIRY

RESPONSE First Given Name

Middle Initial

Surname

Date of Birth (day / month / year)

No Liens Liens (Via Fax)

Address:

RESPONSE First Given Name

Middle Initial

Surname

Date of Birth (day / month / year)

No Liens Liens (Via Fax)

Address:

RESPONSE

BUSINESS DEBTOR NAME ENQUIRY

No Liens Liens Business, Corporate, Partnership or Other Name (As applicable)

(Via Fax)

Address:

Member Name:

Contact:

Fax:

9 Complete form using BLOCK LETTERS ONLY. 9 All information requested MUST be completed and spelling must be correct for an accurate search to be conducted. RESPONSE: The “No Liens” box will be checked by the Lien Search Operator of no liens are found. The “Liens Via Fax” box will be checked if liens are found and a copy of the lien information will be included in the return fax.