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Free Michigan Sworn Template in PDF

The Michigan Sworn form is a legal document used by contractors and subcontractors to declare the status of payments owed to subcontractors, suppliers, and laborers for construction projects. This form ensures that the property owner is informed of any outstanding claims related to construction liens. It serves as a crucial tool in maintaining transparency and protecting the interests of all parties involved in a construction contract.

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The Michigan Sworn form plays a crucial role in construction projects, ensuring transparency and accountability among contractors, subcontractors, suppliers, and laborers. This form serves as a sworn statement, where the contractor or subcontractor affirms their responsibility for the improvement of a specified property. It includes detailed information about each subcontractor, supplier, and laborer involved in the project, as well as the amounts owed for their services. By providing a comprehensive breakdown of contracts, payments, and outstanding balances, the form helps clarify financial obligations and protect all parties involved. Furthermore, it emphasizes the importance of accuracy; any false statements can lead to serious legal consequences. Notably, the form also includes warnings for both the owner and the deponent, highlighting the potential risks associated with relying on the information provided. Overall, the Michigan Sworn form is a vital document that safeguards the interests of everyone engaged in a construction project.

Form Example

SWORN STATEMENT
State of
County of
being duly sworn, deposes and says that	is the contractor/subcontractor for an
improvement to the following described real property situated in	County, Michigan described as follows
Project Name:
Address

That the following is a statement of each subcontractor and supplier and laborer, for which the payment of wages or fringe benefits and withholdings is due but unpaid, with whom the contractor/subcontractor has contracted/subcontracted for performance under the contract with the owner or lessees thereof, and that the amounts due to the persons as of the date hereof are correctly and fully set forth opposite their names as follows:

	Subcontractor,	Type of Improvement	Total	Adjusted	Amount	Amount	Balance to
No.	Subcontractor,	Type of Improvement	Contract	Contract	Amount	Currently	Balance to
No.	Supplier, or Laborer	Furnished	Contract	Contract	Already Paid	Currently	Complete
	Supplier, or Laborer	Furnished	Price	Price	Already Paid	Owing	Complete
			Price	Price		Owing
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

		Totals

That the contractor has not procured material from, or subcontracted with, any person other than set forth and owes no money for the improvement other than the sums set forth above.

Deponent further says that he or she makes the foregoing statement as the (contractor) (subcontractor)

or as of the (contractor) (subcontractor) for the purpose of representing to the owner or lessee of the above described premises and his or her agents that the above described property is free from claims of construction liens, or the possibility of construction liens, except as specifically set forth above and except for claims of construction liens by laborers which may be provided pursuant to section 109 of the construction lien act, Act NO. 497 of the Public Acts of 1980, as amended, being section 570.1109 of the Michigan Compiled Laws.

WARNING TO OWNER: AN OWNER OR LESSEE OF THE ABOVE DESCRIBED PROPERTY MAY NOT RELY ON THIS SWORN STATEMENT TO AVOID THE CLAIM OF A SUB-CONTRACTOR SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OR FURNISHING OR A LABORER WHO MAY PROVIDE A NOTICE OF FURNISHING PURSUANT TO SECTION 109 OF THE CONSTRUCTION LIEN ACT TO THE DESIGNEE OR TO THE OWNER OR LESSEE IF THE DESIGNEE IS NOT NAMED OR HAS DIED

WARNING TO DEPONENT: A PERSON, WHO WITH INTENT TO DEFRAUD, GIVES A FALSE SWORN STATEMENT IS SUBJECT TO CRIMINAL PENAL TIES AS PROVIDED IN SECTION 110 OF THE CONSTRUCTIN LIEN ACT. ACT NO. 497 OF THE PUBLIC ACTS OF 1980, AS AMENDED, BEING SECTION 570.1110 OF THE MICHIGAN COMPILED LAWS.

		Deponent
Subscribed and sworn to before me this				day of
	20 _____
Notary Public,			County, Michigan
My commission expires:

Page 4 of 4

▼ Michigan Sworn PDF Form

Document Specs

Fact Name	Description
Purpose	The Michigan Sworn Statement serves to confirm that the contractor or subcontractor has paid all subcontractors, suppliers, and laborers involved in a construction project, ensuring the property is free from claims of construction liens.
Governing Law	This form is governed by the Michigan Construction Lien Act, specifically Act No. 497 of the Public Acts of 1980, as amended, found in section 570.1109 and section 570.1110 of the Michigan Compiled Laws.
Warnings	The form includes warnings to both the owner and the deponent. Owners should not rely solely on this statement to avoid claims from subcontractors or laborers. Deponents face criminal penalties for providing false information.
Notarization	The Sworn Statement must be subscribed and sworn before a notary public, ensuring the authenticity of the declaration made by the contractor or subcontractor.

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