Record and Return to:

File No: ___ Prepared by: ___

File No: ___ Prepared by: ___ Name: ___ Permit No.: ___ Address: ___ Key No. ___ Tax Folio/Parcel ID: ___

The quick brown fox jumps over the lazy dog.

NOTICE OF COMMENCEMENT

State of Florida

County of ___

THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida State Statutes, the following information is provided in this Notice of Commencement.

  1. Description of Property: (Legal description of the property):___ Property Address:___
  2. General Description of Improvement: ___
  3. Owner Infonnation: Name:___ Address:___ City:___ State___ Interest in Property:___ Name and Address of Fee Simple Titleholder (If other than owner):___
  4. Contractor: Name: ___
  5. Surety: Name: ___ Amount of Bond $___
  6. Lender: Name: ___
  7. Address: ___ City: ___ State ___ Phone No: ___ Fax No: ___
  8. Phone No. _____ Fax No. _____
  9. Address: ___ City: ___ State ___ Phone No. ___ Fax No. ___
  10. Address: ___ City: ___ State ___ Phone No. ___ Fax No. ___
  11. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)(7). Florida Statutes: Name:
  12. Name: ___
  13. Address: ___ City: ___ State: ___ Phone No: ___
  14. Phone No. ___ Fax No. ___
  15. In addition to himself or herself, Owner designates ___ of
  16. to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b). Florida Statutes.
  17. Expiration date of Notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified).

WARNING TO OWNER: ANY PAYMENTS MADE BY THE OW NER AFTER THE EXPIRATION OF THE NO TICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SEC 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 J OB SITE BEFORE THE FI RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCI NG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.

Signature of Owner or Owner's Authorized Officer/Director/Partner/Manager

Tul-10ff

Signatory's Title/Office

State of Florida, County of _____

regoing instrument was acknowledged before me this_____ day of_____，20_by_—◆—◆—" as

(Name of Person)

ー ＝ ＝

·..... =.....

(Type of authority e.g., office, trustee, attorney in fact)

(Name of party on behalf of who instrument was executed)

(Name of party on behalf of who instrument was executed)

（2）

Signature of Notary

Personally known ___ OR Produced Identification ___ Type of Identification Produced:

Print, Type or Stamp Name of Notary

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

Jan 2020