Fill and Sign the California Owner Construction Form

OWNER’S WRITTEN NOTICE OF LIEN RELEASE BOND [Individual 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       . Owner’s Written Notice of Lien Release Bond Page 1 of 3 CA Civil Code § 8522 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 by 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:       Signature       Type or Print Name Owner’s Written Notice of Lien Release Bond Page 2 of 3 CA 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 ______________________ ( subscribing witness’s name), who proved tome the basis of satisfactory evidence to be the person(s) whose name(s) Owner’s Written Notice of Lien Release Bond Page 3 of 3 CA Civil Code § 8522 is/are subscribed to the within instrument, as a witness thereto, who, being by me duly sworn, deposed and said that he/she was present and saw/heard acknowledged ______________________ (names(s) of principal(s)), the same person(s) described in and whose name(s) is/are subscribed to the within and annexed instrument in his/her/their authorized capacity(ies) as (a) party(ies) thereto, execute the same, and that said affiant subscribed his/her name to the within instrument as a witness at the request of ______________________ (name(s) of principal(s). 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) Owner’s Written Notice of Lien Release Bond Page 4 of 3 CA Civil Code § 8522