Notice Of Commencement Form - State Of Florida, County Of Okaloosa
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1Permit # __________________
(3/24/2011)
NOTICE OF COMMENCEMENT
State of Florida, County of Okaloosa
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.
Legal Description of Property: ____________________________________________________________________
Street Address: ______________________________________________ City: ____________________________
General Description of Improvements: _____________________________________________________________
Owner’s Name: _______________________________________________________________________________
Owner’s Address: ____________________________________________ City: ____________________________
Owner’s Interest in Property: _____________________________________________________________________
Name and Address of Fee Simple Titleholder (if other than owner): ______________________________________
General Contractor
Name: _________________________________________________________ Phone #: ____________________
Address: ____________________________________________________ City: ___________________________
Name and Address of the Surety on the Payment Bond under s. 713.23, if any and the amount of such bond:
Name: _________________________________________________________ Phone #: _____________________
Address: _______________________________________________________ Amount of bond: $_____________
Lender’s Name: _________________________________________________ Phone #: _____________________
Address: ____________________________________________________ City: ___________________________
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: _________________________________________________________ Phone #: _____________________
Address: _____________________________________________________________________________________
In addition to him or herself, 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: _________________________________________________________ Phone# _______________________
Expiration date of the Notice of Commencement is one (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 1, 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.
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 Owner OR Owner’s Authorized
Signatory’s Title
Officer/Director/Partner/Manager
The foregoing instrument was acknowledged before me this _________ day of __________________, 20____,
by _______________________________, who produced ___________________________________________ as
Identification and who did not take an oath.
__________________________________________
__________________________________________
NOTARY
MY COMMISSION EXPIRES:
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