Advantage Lien Protection, LLC.

Effective, Economical Lien Right Protection

Service Application

1. Company Information

Name/dba

FEIN

Mail Address

Principal State(s) of Business

City

State

Zip

Physical Address

Zip

Phone

Fax

Home

Trade(s) or Profession

Usual Job Tier

Projects Value Range: Low High

Projects per Year

Number of Employees

State License Number

2. Contact Information

First Name

Last Name Title

Cell Phone

Alternate Contact

Alternate Email

Additional Parties

Best Time

3. Select Your Service Plan

Service Plan	FAX Orders & Updates	Online Order	Online Reminder Report	E-mail Reminder Report	E-Lien Alert	Mail Mo. Reminder Report	Date- Tracker	Fee
Basic Service								Included
Basic + Mail								+ $75 / yr
Advantage Plus								+ $300 / yr

(Subcontractors) Should we send copy of Notices to your hiring party?

4. Trade or Professional Memberships

5. Charges and Invoicing

Prepaid Prelien Plan

Credit Card Payment

Important: There is a One-time new client origination fee of $200 in addition to any charges that apply to the service plan you select. Any Service Order(s) you submit now are billed seperately. (Please request a Fee Schedule for details.)
You will be given an opportunity to verify your information and the amount due before any charges are incurred.

Please call for assistance.

6. Web Access

Please choose a username and password for access to your online account features.

User name:
Password:

7. This application for enrollment subject to terms of Service Agreement and is not a contract until and only if accepted in writing by both parties. Limited offer.

Service subject to ALP Service Agreement.

ALL fields must be filled in to process your request