Fill and Sign the Business Entity as Owner Form

Owner’s Written Notice of Lien Release Bond Page 1 of 3CA Civil Code § 8522 OWNER’S WRITTEN NOTICE OF LIEN RELEASE BOND [Business Entity as Owner] To: Lien Claimant: Street Address: City, State and Zip Code: Name of owner giving notice: Street Address: City, State and Zip Code: Relationship to other parties: Name of direct contractor: 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, , and would provide notice of the following: 1.On or about , 20 , a lien was claimed against the above described property by . 2. On or about , 20 , a Stop Payment Notice was received by the undersigned from . 3.On or about , 20 the undersigned recorded in the office of the county recorder in which said lien was claim of lien was recorded, a bond executed Owner’s Written Notice of Lien Release Bond Page 2 of 3CA Civil Code § 8522by a corporation authorized to issue surety bonds in the State of California, in the amount of $ . 4.Pursuant to California Civil Code § 8522(b), a copy of said bond is attached to this notice. Date: Name of Entity: ATTESTED BY: (if required) A Corporation By: Signature Signature of authorized signatory Type or Print NameType or Print Name Its: Position or Rank Capacity of Signatory Owner’s Written Notice of Lien Release Bond Page 3 of 3CA Civil Code § 8522 PROOF OF NOTICE DECLARATION (Civil Code § 8118) I, , declare that I have served copies of the OWNER’S WRITTEN NOTICE OF LIEN RELEASE BOND 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. b. By Certified, Express, or Registered Mail Service, postage prepaid addressed to: Name: Title: At: Street Address: City, State and Zip Code: On: , 20 , at am / pm. 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 ATTACH SERVICE LIST OF CERTIFIED OR REGISTERED MAIL WHEN RETURNED, OR PHOTOCOPY OF POST OFFICE RECORD OF DELIVERY OF RECEIPT. 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 satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and Owner’s Written Notice of Lien Release Bond Page 4 of 3CA Civil Code § 8522acknowledged 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)