This Instrument Prepared By: Name ___________________________________ Address ___________________________________ Permit No. ____________________ Tax Folio No. ____________________ 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 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: a. Name and address: b. Phone number: c. Fax number (optional, if service by fax is acceptable): 5. Surety a. Name and address: b. Amount of bond $ __________ c. Phone number: d. Fax number (optional, if service by fax is acceptable): 6. Lender a. Name and address: b. Phone number: c. Fax number (optional, if service by fax is acceptable): 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(l)(a)7., Florida Statutes: a. Name and address: b. Phone number: c. Fax number (optional, if service by fax is acceptable): 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienors Notice as provided in Section 713.13(l)(b), Florida Statutes: a. Name and address: b. Phone number: c. Fax number (optional, if service by fax is acceptable): 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified) ____________________ Signature of Owner _________________________ Owner's Name _________________________ Owner's Address _________________________ Sworn to and subscribed before me by _________________________ who is personally known to me or produced _________________________ as identification, and who did ___ take an oath, this __________ day of ____________________, 20 ____. Signature of Notary _________________________ Printed Name of Notary _________________________ Commission No./Expiration _________________________ SEAL: ALL INFORMATION MUST BE TYPED OR PRINTED LEGIBLY TO COMPLY WITH RECORDING REQUIREMENTS.