Fill and Sign the Instruction Sheet Proof of Service of Notice of Form

Notice of Commencement Page 1 of 3 Prepared by, recording requested by and return to: Name: ___________________ Company: ____________________ Address: ______________________ City: __________________ State: _____ Zip: __________ Phone: _________________ Fax: _________________ NOTICE OF COMMENCEMENT-CORPORATION (M.S.A. §570.1108) To lien claimants and subsequent purchasers: Take notice that work is about to commence on an improvement to the real proper ty described in this instrument. A person having a construction lien may preserve the lien by providing a Notice of Furnishing to the below named Designee and the General Contractor, if any, and by timely recording a claim of lien, in ac cordance with law. A person having a construction lien arising by virtue of work performed on this improvement should refer to the name of the Owner or Lessee and the legal description appearing in this notice. A person subseque ntly acquiring an interest in the land described is not required to be named in a claim of lien. A copy of this Notice with an attached form for Notice of Furnishing may be obtained upon ma king a written request by, certified mail to the named Owner or Lessee, the Designee, or the person with whom you have contracted. State of Michigan ) ) ss County of ) __________________________________ the undersigned, as __________________________________ of __________________________________, a _______________________________ corporation, being duly sworn, deposes and says: The legal description of the real property on which the improvement is to be made is ( include property tax identification number and address): ____________________________________________________________________________________________ ____________________________________________________________________________________________ _______________________________________________________________________ The name, address and capacity of the Owner or Lessee of the real property contracti ng for the improvement is: Name: ___________________________________ Address: ___________________________________ Capacity: ___________________________________ The name and address of the Fee Owner of the real property, if the person contracting f or the improvement is a land contract vendee or lessee, is: Notice of Commencement Page 2 of 3 Name: __________________________________ Address: __________________________________ The name and address of the Owner's or Lessee's Designee is: Name: ___________________________________ Address: ___________________________________ The name and address of the General Contractor, if any, is: Name: __________________________________ Address: __________________________________ (Name of person with whom you have contracted to provide substantially all the improvem ents to the property) ____________________________________________ Owner or Lessee By_______________________________________ (Signature and capacity of person signing) ___________________________________________ Type or Print Name ___________________________________________ Title ___________________________________________ Name of Corporation Attest: Secretary Subscribed and sworn to by _______________________ before me on the ___ day of 20____ . Signature: _________________________________ Printed Name: ______________________________ Notary public, State of Michigan, County of __ My commission expires______________________ NOTE: ATTACH NOTICE OF FURNISHING HERE TO UNLESS THIS DOCUMENT IS TO BE RECORDED. Prepared By: Name: _______________________________________________ Address: ____________________________________________ Notice of Commencement Page 3 of 3 *WARNING TO HOMEOWNER: Michigan law requires that you do the following: 1. COMPLETE AND RETURN THIS FORM TO THE PERSON WHO ASKED FOR I T WITHIN 10 DAYS AFTER THE DATE OF THE POSTMARK ON THE REQUEST. 2. IF YOU DO NOT COMPLETE AND RETURN THIS FORM WITHIN THE 10 DAYS YOU MAY HAVE TO PAY THE EXPENSES INCURRED IN GETTING THE INFORMATION. 3. IF YOU DO NOT LIVE AT THE SITE OF THE IMPROVEMENT, YOU MUST POST A COPY OF THIS FORM IN A CONSPICUOUS PLACE AT THAT SITE.