Washington Model Disclosure Statement Form
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Get help filing your Washington Preliminary Notice
Washington contractors who have a contract with the property owner can use this free Model Disclosure Statement form to protect their right to file a lien if unpaid.
Prime contractors must provide a type of preliminary notice in Washington known as a Model Disclosure Statement form prior to starting work on a construction project.
The Model Disclosure Statement is a type of preliminary notice. It is used on construction projects to protect a direct contractor’s right to file a mechanics lien in Washington if unpaid for work or materials.
This disclosure statement is given to the consumer (customer) from the contractor showing they are registered in the state of Washington. It provides a warning that the contractor may file a mechanics lien if the customer does not pay for the work or materials. The consumer (customer) must sign this form as acknowledgment of receipt.
Note that contractors must “retain a signed copy of the disclosure statement in his or her files for a minimum of three years.” They must provide a signed or electronic signature copy of the disclosure statement to the Washington Department of Labor and Industries upon request.
This form meets the requirements set forth in Washington Statute Chapter 60.04 – Mechanics’ and Materialmens’ Liens.
Rules and regulations for sending a Washington Preliminary Notice
Statutory Model Disclosure Statement should be provided to the customer immediately prior to beginning work.
After completing the Washington Model Disclosure Statement Form, you must deliver it to the appropriate parties required by statute. Notices are typically served on the property owner and, for sub-tier parties, the general contractor. However, depending on the type of notice, it can be helpful to send notices to anyone else who is in charge of your payment, like a lender or surety company on the project.
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Other forms to use in Washington
Washington County Recorders
Looking to file/record a mechanics lien in Washington? You'll need to get your Washington mechanics lien filed and recorded with the county recorder in the county where the construction project is located. Here is a listing of all county recorders in Washington. Click on any county to find more information about how to get your lien recorded in that county.
Benton
620 Market St
Prosser, Washington, 99350
Phone: 509-736-2727
Fax: 509-736-2700
Chelan
350 Orondo Avenue
Wenatchee, Washington, 98807
Phone: 509-667-6815
Fax: 509-667-6825
Cowlitz
207 4th Ave. N
Kelso, Washington, 98626
Phone: 360-577-3006
Fax: 360-414-5552
Franklin
1016 N. 4th Ave.
Pasco, Washington, 99301
Phone: 509-545-3502
Fax:
Grant
35 C St. NW
Ephrata, Washington, 98823
Phone: 509-754-2011
Fax: 509-754-6575
Grays Harbor
100 W Broadway Suite 2
Montesano, Washington, 98563
Phone: (360) 964-1557
Fax:
Island
P.O. Box 5000
Coupeville, Washington, 98239-5000
Phone: 360-240-5549
Fax: 360-240-5565
Jefferson
1820 Jefferson Street
Port Townsend, Washington, 98368
Phone: 360-385-9115
Fax:
Kitsap
619 Division St
Pt. Orchard, Washington, 98366-4687
Phone: 360-337-4935
Fax: 360-337-4645
Kittitas
205 W 5th AVE Suite 105
Ellensburg, Washington, 98926
Phone: 509) 962-7504
Fax: 509-962-7687
Lewis
351 NW North Street
Chehalis, Washington, 98532
Phone: 360-740-1156
Fax:
Lincoln
450 logan st
Davenport, Washington, 99122
Phone: (509)725-4971
Fax: 509-725-0820
Mason
P.O. Box 400 411 N 5th Street
Shelton, Washington, 98584
Phone: 360) 427-9670
Fax: (360) 427-1753
Pacific
300 Memorial Dr
South Bend, Washington, 98586
Phone: (360) 875-9318
Fax: 360-875-9333
Pend Oreille
625 W 4th Street
Newport, Washington, 99156
Phone: (509) 447-6474
Fax:
San Juan
350 Court Street
Friday Harbor, Washington, 98250
Phone: 360) 378-2161
Fax: 360-378-6256
Skagit
700 s. second st administration building, room 201
Mt Vernon, Washington, 98273
Phone: 3603369420 ext 3
Fax: 360-416-1698
Skamania
240 NW Vancouver Ave Attn: Recording
Stevenson, Washington, 9864
Phone: (509) 427-3730
Fax: (509) 427-3740
Snohomish
3000 Rockefeller Avenue, M/S 204
Everett, WA 98201
Spokane
ATTN: RECORDING 1116 West Broadway Avenue
Spokane, WA 99210
Stevens
215 South Oak Street
Colville, Washington, 99114
Phone: 509-684-6161
Fax: 509-684-7580
Thurston
2000 Lakeridge Dr. SW
Olympia, Washington, 98502
Phone: 360-786-5405
Fax: 360-786-5223
Walla Walla
Second Floor, Rm 201 - 315 West Main St
Walla Walla, Washington, 99362
Phone: 509-524- 2549
Fax:
Whatcom
311 Grand Avenue, Suite 103
Bellingham, Washington, 98225
Phone: 360-778-5100 press 2
Fax: 360-778-5101
Whitman
400 N. Main Street Attn: Recording
Colfax, Washington, 99111
Phone: (509) 397-6270
Fax:
Yakima
128 N 2nd St, Room 117
Yakima, Washington, 98901
Phone: 509) 574-1330
Fax: 509) 574-1341