Fill and Sign the 10 Day Work California Form

10-DAY STOP WORK NOTICE (Individual as Direct Contractor) Name of direct contractor:       Street Address:       City, State and Zip Code:       Name of owner or reputed owner:       Street Address:       City, State and Zip Code:       Name of construction lender:       Street Address:       City, State and Zip Code:       Site of the Improvement: Street Address:       City, State and Zip Code:       Legal Description:       COMES NOW,       , the direct contractor for the private work of improvements to the property at the above improvement site, who has not been paid all moneys which are owed pursuant to a written contract for such improvements within thirty-five (35) days from the date payment was due pursuant to the written contract, and for which there is no dispute as to the satisfactory performance, and states that unless all amounts due the undersigned are paid within ten (10) days from the date of this notice, the undersigned original contractor will stop work on the project. Date:       Signature       Type or Print Name Ten Day Stop Work Notice Page 1 of 3 CA Civil Code § 8832 PROOF OF NOTICE DECLARATION (Civil Code § 8118) I,       , declare that I have served copies of the TEN DAY STOP WORK ORDER by (check appropriate box below): a. By personally delivering copies to: Name:       Title:       At: (Street Address)       City, State and Zip Code:       On:       , 20       , at       am / pm. [Provide the above information for all other parties personally served on attached Exhibit A] b. By Certified, Express, or Registered Mail Service, postage prepaid addressed to: Name:       Title:       At: Street Address:       City, State and Zip Code:       On:       , 20       [Provide the above information for all other parties served by mail / express service on attached Exhibit A] See attached documentation provided by the US Postal Service or express mail service showing the date of delivery and the name of the person accepting delivery; tracking record or other documentation from express carrier showing attempted delivery or delivery of the notice; or, in the event of non-delivery, the returned envelope itself. I declare under penalty of perjury that the foregoing is true and correct. Signed at       , California , on       , 20 ______ . Signature       Print or Type Name A notary public or other officer completing the certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of ______________________ On ______________________ before me, ______________________ (here insert name and title of the officer), personally appeared ______________________ , who proved to me on the basis of Ten Day Stop Work Notice Page 2 of 3 CA Civil Code § 8832 satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. _____________________________________________ Signature (Seal) Ten Day Stop Work Notice Page 3 of 3 CA Civil Code § 8832