Fill and Sign the Individual as Owner Form

Notice That Notice of Completion Has Been Recorded Page 1 of 4CA Civil Code § 8190 NOTICE THAT NOTICE OF COMPLETION HAS BEEN RECORDED (Individual as Owner) Name of owner: Street Address: City, State and Zip Code: 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, , as the owner of the private work of improvement at: Street Address: City, State, Zip: and provides notice to the direct contractor and any claimant, other than the direct contractor, who has given preliminary notice in accordance with § 8202, that a Notice of Completion has Notice That Notice of Completion Has Been Recorded Page 2 of 4CA Civil Code § 8190been recorded. This notice is being provided within ten (10) days after recordation of the Notice of Completion.Date: Signature Type or Print Name Note: Failure to give notice to a contractor or claimant within ten (10) days of recording the notice of completion means the notice is ineffective to shorten the time within which that person may record a claim of lien under section 8412 and 8414. The ineffectiveness of the notice is the sole liability of the owner for failure to give notice to a person under § 8190(a). Notice That Notice of Completion Has Been Recorded Page 3 of 4CA Civil Code § 8190 PROOF OF NOTICE DECLARATION (Civil Code § 8118) I, , declare that I have served copies of the NOTICE THAT NOTICE OF COMPLETION HAS BEEN RECORDED 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 , at am / pm.[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 NameA 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 Notice That Notice of Completion Has Been Recorded Page 4 of 4CA Civil Code § 8190acknowledged 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)