NOTICE OF LIEN UNDER TENNESSEE COAL SURFACE MINING LAW OF 1980
Name of titleholder(s)
Property address
Description of property subject to possible lien sufficient to identify such property
Date, signature, and address of the commissioner or the commissioner's authorized designee
The register of deeds shall note the date and time of filing, and an appropriate registration number, and shall record the notice in the lien book in the office of the register.