Notice of Commencement

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AFTER RECORDING RETURN TO:

BE SURE TO PRINT THIS ENTIRE FORM.

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PERMIT NUMBER: _________________________

NOTICE OF COMMENCEMENT
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 & street address, if available) TAX FOLIO NO.: ____________________

SUBDIVISION _______________________________BLOCK_________TRACT_________LOT________BLDG_______UNIT_______

__________________________________________________________________________________________________________

2. GENERAL DESCRIPTION OF IMPROVEMENT:


__________________________________________________________________________________________________________

3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:

a. Name and address: __________________________________________________________________________________________________________________

b. Interest in property: __________________________________________________________________________________________________________________

c. Name and address of fee simple titleholder (if different from Owner listed above): ________________________________________________________________

4. a. CONTRACTORS NAME: __________________________________________________________________________________


Contractors address: _____________________________________________________________________ b. Phone number: ____________________________

5. SURETY (if applicable, a copy of the payment bond is attached):

a. Name and address: ___________________________________________________________________________________________________________________

b. Phone number: _______________________________________________________ c. Amount of bond: $_____________________________________________

6. a. LENDERS NAME: _____________________________________________________________________________________________________________


Lenders address: ________________________________________________________________________b. Phone number:____________________________

7. 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:
a. Name and address: __________________________________________________________________________________________________________________

b. Phone numbers of designated persons: ___________________________________________________________________________________________________

8. a. In addition to himself or herself, Owner designates ___________________________of ________________________________


to receive a copy of the Lienors Notice as provided in Section 713.13 (1) (b), Florida Statutes.
b. Phone number of person or entity designated by Owner: _____________________________________________________________________________________

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):______________, 20____
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.

________________________________________________________ ____________________________________________________
(Signature of Owner or Lessee, or Owners or Lessees (Print Name and Provide Signatorys Title/Office)
Authorized Officer/Director/Partner/Manager)

State of ___________________
County of _________________

The foregoing instrument was acknowledged before me this __________ day of _______________, 20______________________

by ___________________________________________________, as ________________________________________________
(name of person) (type of authority,e.g. officer, trustee, attorney in fact)
for __________________________________________________.
(name of party on behalf of whom instrument was executed)

Personally Known _____ or Produced Identification______ Type of Identification Produced _____________________________

Notary _______________________________________________
(Signature of Notary Public)
(Print, Type, or Stamp Commissioned Name of Notary Public)

Rev. 10-15-12

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