Notice Of Commencement Form

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This instrument prepared by & return to:
Name: _________________________________
Address:________________________________
Parcel I.D. #:_____________________________
_____________SPACE ABOVE THIS LINE FOR PROCESSING DATA_________________SPACE ABOVE THIS LINE FOR RECORDING DATA_________
NOTICE OF COMMENCEMENT
STATE OF ___________________
COUNTY OF _________________
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 property, and street address if available.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
2.
General Description of improvement: ________________________________________________________________
3.
Owner information:
a.
Name and Address: ________________________________________
b.
Interest in Property: ________________________________________
c.
Name and Address of Fee Simple Titleholder (if other than owner):________________________________
_______________________________________________________________________________________
4.
Contractor: (Name and Address)
___________________________________________
___________________________________________
___________________________________________
Telephone Number: ___________________________
5.
Surety:
a.
Name and Address: ___________________________________________
Telephone Number: ___________________________________________
b. Amount of Bond: _____________________________________________
6.
Lender: Name and Address: ___________________________________________
Telephone Number: ___________________________________________
7.
Persons within the State of Florida designated by Owner upon whom notice or other documents may be served as
Provided by Section 713.13(1)(a)7, Florida Statutes: (Name and Address)
8.
In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor’s Notice as provided
In Section 713.13(1)(b), Florida Statutes: (Name and Address)
Telephone Number: ____________________________________________________
9.
Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording unless a
different date is specified) _______________________________________________.
_____________________________________________
___________________________________________
_____________________________________________
____________________________________________
Sworn to and subscribed before me this _____ day of ________________, by ______________________________, who is/are
personally known to me or who has/have produced ____________________ as identification and who did/did not take an oath.
___________________________________
/-----Notary Public Rubber Stamp Seal-----/
Notary Public

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