Permit Number: _____________________________________ Folio/Parcel ID #: ____________________________________ Prepared by: _______________________________________ __________________________________________________ __________________________________________________ Return to: __________________________________________ __________________________________________________ __________________________________________________ State of Florida, County of Orange The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property (legal description of the property, and street address if available) _______________________________________________________________________________________ 2. General description of improvement _______________________________________________________________________________________ 3. Owner information or Lessee information if the Lessee contracted for the improvement Name__________________________________________________________________________________ Address________________________________________________________________________________ Interest in Property________________________________________________________________________ Name and address of fee simple titleholder (if different from Owner listed above) Name__________________________________________________________________________________ Address________________________________________________________________________________ 4. Contractor Name_________________________________________________Telephone Number__________________ Address________________________________________________________________________________ 5. Surety (if applicable, a copy of the payment bond is attached) Name_________________________________________________Telephone Number__________________ Address_______________________________________________Amount of Bond $___________________ 6. Lender Name_________________________________________________Telephone Number__________________ Address________________________________________________________________________________ 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by §713.13(1)(a)7, Florida Statutes. Name_________________________________________________Telephone Number__________________ Address________________________________________________________________________________ 8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in §713.13(1)(b), Florida Statutes. Name_________________________________________________Telephone Number__________________ Address________________________________________________________________________________ 9. Expiration date of notice of commencement (the expiration date will be 1 year from the date of recording unless a 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE OF COMMENCEMENT Signature of Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager Signatory's Title/Office The foregoing instrument was acknowledged before me this as Type of authority, e.g., officer, trustee, attorney in fact day of for month/year by name of person Name of party on behalf of whom instrument was executed Signature of Notary Public ­ State of Florida Print, type, or stamp commissioned name of Notary Public Personally Known Type of ID Produced OR Produced ID American LegalNet, Inc. www.FormsWorkFlow.com Form content revised: 01/23/14