California Preliminary Notice Form/proof Of Notice Declaration
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1
2CALIFORNIA PRELIMINARY NOTICE
(For use on Private and Public Works)
See Civil Code Sections 8200, et seq., 9300, et seq.
OWNER
PUBLIC ENTITY
YOU ARE HEREBY NOTIFIED THAT . . .
or
or Reputed Owner
(public work)
(private work)
___________________________________________________________
__________________________________________________________
name of person or firm furnishing labor, services, equipment or material)
(
(name)
___________________________________________________________
__________________________________________________________
(address of person or firm furnishing labor, services, equipment or material)
(address)
Telephone (
) ___________________________________
__________________________________________________________
(city)
(state)
(zip code)
___________________________________________________________
(relationship of claimant to the parties)
DIRECT CONTRACTOR or
has furnished or will furnish labor, services, equipment or materials of
Reputed Direct Contractor, if any
the following general description:
(private and public work)
_________________________________________________________
(general description of the labor, services, equipment or material furnished or to
___________________________________________________________
be furnished)
(name)
for the building, structure or other work of improvement located at:
___________________________________________________________
(address)
___________________________________________________________
address or description of job site sufficient for identification, including street
(
___________________________________________________________
address, if any)
(city)
(state)
(zip code)
___________________________________________________________
CONSTRUCTION LENDER or
___________________________________________________________
Reputed Construction Lender, if any
(private work)
The name of the person or firm who contracted for the purchase of such
labor, services, equipment or material is:
_________________________________________________________
(name)
___________________________________________________________
_________________________________________________________
___________________________________________________________
(address)
___________________________________________________________
_________________________________________________________
(city)
(state)
(zip code)
An estimate of the total price of the labor, services, equipment or
materials furnished or to be furnished is:
NOTICE TO PROPERTY OWNER
$
EVEN THOUGH YOU HAVE PAID YOUR CONTRACTOR IN FULL, if
the person or firm that has given you this notice is not paid in full for labor,
service, equipment, or material provided or to be provided to your
Identify all laborers not paid compensation when due, and any person or
construction project, a lien may be placed on your property. Foreclosure of
entity to whom a portion of a laborer’s compensation is paid.
the lien may lead to loss of all or part of your property. You may wish to
protect yourself against this by (1) requiring your contractor to provide
(Material suppliers not required to furnish)
signed release by the person or firm that has given you this notice before
making payment to your contractor, or (2) any other method that is
___________________________________________________________
appropriate under the circumstances. This notice is required by law to be
(name)
(address)
served by the undersigned as a statement of your legal rights. This notice is
not intended to reflect upon the financial condition of the contractor or the
___________________________________________________________
person employed by you on the construction project. If you record a notice
(name)
(address)
of cessation or completion of your construction project, you must within 10
days after recording, send a copy of the notice of completion to your
___________________________________________________________
contractor and the person or firm that has given you this notice. The notice
name)
(address)
(
must be sent by registered or certified mail. Failure to send the notice will
extend the deadline to record a claim of lien. You are not required to send
the notice if you are a residential homeowner of a dwelling containing four or
Dated: _____________________________________________________
fewer units.
By:________________________________________________________
Signature
C&B Revised 7-1-2012
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