This assignment is made on     [date]     by   [name of lienholder]    ， of     [address]    ， City of [city] ，County of     [county]    ， State of  [state]  ， herein referred to as "Assignor"， to   [name of assignee] ， of [address]  ， City of   [city]  ， County of   [county]， State of [state]， herein referred to as "Assignee".

　　In consideration of  [amount]                  Dollars，（$      ）， receipt of which is hereby acknowledged，assignor does hereby assign to assignee the mechanic's lien on the property of     [name of property owner]  ，located at  [address]    ，     [city]    ，   [state]  ，which has been duly recorded in the office of [office]，in Volume   [number]   ， page      ， a copy of which is attached hereto.

　　Whereas， the intent of this assignment is to transfer to assignee full power to collect that certain sum secured by said lien， assignor does hereby appoint assignee his attorney in fact， with full authority to enforce the lien herein assigned， and to collect and receive the debt secured by said lien， as assignor would do if this assignment were not being made.  Any costs incurred² by the assignee in enforcing the assigned lien， shall be borne by the assignee.

　　In witness， whereof， assignor has executed this assignment at [place of execution]， this [day] of [month]    ， [year]

　　_______________________

　　[Signature]

　　[Acknowledgment]