Permit No. _________________________ Tax Folio No. _________________________ NOTICE OF COMMENCEMENT To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. 1. Description of property: Legal Description: _________________________________________________________________ Street Address: _________________________________________________________________ 2. 3. General description of improvements: ___________________________________________________ Owner's Information: Name: _______________________________________________________ Address: _____________________________________________________ Interest in Property: _____________________________________ Name and Address of fee simple titleholder (if other than owner): _____________________________________________________________ 4. Contractor Information: Name: _______________________________________________________ Address: _____________________________________________________ Telephone No. _____________________ Fax No. (Opt.) ______________ Surety Information: Name: ________________________________________________________ Address: ______________________________________________________ Amount of Bond: _______________________________________________ Telephone No. _____________________ Fax No. (Opt.) ______________ Name: ________________________________________________________ Address: ______________________________________________________ Telephone No. _____________________ Fax No. (Opt.) _______________ 5. 6. Lender Information: 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: Name: ________________________________________________________ Address: ______________________________________________________ Telephone No. ____________________ Fax No. (Opt.) _______________ 8. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as Provided in Section 713.13 (1) (b), Florida Statutes: Name: ________________________________________________________ Address: ______________________________________________________ Telephone No. ____________________ Fax No. (Opt.) ________________ 9. Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording unless Different date is specified) ________________________. WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCEING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. _____________________________________________________ Signature of Owner or Owner's Authorized Officer/Director/ Partner/Manager _____________________________________________________ Print Name State of Florida County of Leon The Foregoing instrument was acknowledged before me this _____ day of ______________________, 20____, by________________________________________________ who is personally known to me or has produced ________________________________ as identification and who did/did not take an oath. Gwen Marshall, Leon Co. Clerk of the Circuit Court & Comptroller ______________________________________________ Signature of Notary/Deputy Clerk ______________________________________________ Printed Name Verification pursuant to Section 92.525, Florida Statutes Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. _______________________________________________ Signature of Natural Person Signing Above American LegalNet, Inc. www.FormsWorkFlow.com