Fill and Sign the Louisiana Quitclaim Deed Form 1 Id5dfbd729e01df

Notice To Owner and Contractor Page 1 of 3Prepared by, recording requested by and return to:Name ______________________Address _________________________City _________________________State _____________Zip _____________Phone ______________________------------------------------------Above this line for Official Use Only ----------------------------------- NOTICE TO OWNER AND CONTRACTOR - CORPORATION STATE OF GEORGIACOUNTY OF ____________________BE IT KNOWN THAT _____________________________________________, an entityhaving a right to a lien on the property described below who does not have privity of contract with the contractor and is providing labor, services, or materials for the improvement of property, files this NOTICE TO OWNER and CONTRACTOR and upon being duly sworn states on oath as follows:1.This Notice is given to the owner or the agent of the owner and to the contractor at the addresses set forth in the Notice of Commencement.2. The name, address, and telephone number of the person providing labor, services, or materials and filing this Notice is:_________________________________________ _________________________________________ _________________________________________ 3.The name and address of each person at whose instance the labor, services, or materials are being furnished:_________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ Notice To Owner and Contractor Page 2 of 34. The name of the project and location of the project set forth in the Notice of Commencement is:__________________________________________________________________ __________________________________________________________________ _________________________________________________________________. 5.A description of the labor, services, or materials being provided and, if known, the contract price or anticipated value of the labor, services, or materials to be provided or the amount claimed to be due, if any, is:__________________________________________________________________ __________________________________________________________________ _________________________________________________________________. 6. This Notice is filed within 30 days from the filing of the Notice of Commencement or 30 days following the first delivery of labor, services, or materials to the property, whichever is later.WITNESS my signature on this the _____ day of _________________, 20_____. ____________________________________ SignaturePrint Name: _________________________ Title: _______________________________Name of Corporation: _________________ Attest: Secretary Affidavit of Service State of ________________County of ____________________I, ________________________________, hereby certify that I have this date sent a true and correct copy of this ______________________________________ by personal service or by U.S. mail, return receipt requested, in accordance with law, to the owner or the agent of the owner and the contractor at the addresses set forth in the Notice of Commencement, which the names and addresses are as follows: __________________________________ __________________________________ __________________________________ Notice To Owner and Contractor Page 3 of 3 __________________________________ DATED this the ______ day of __________________, 20______. _____________________________Signature _____________________________ Type or Print Name Sworn to and executedin the presence of:_______________________ (Witness)Sworn to (or affirmed) and subscribed before me this ____ day of __________ (month), __________ (year), by _______________________ (name of person making statement)._______ Personally Known_______ Produced IdentificationType and # of ID __________________________ ____________________________(Signature of Notary) (Seal) _____________________________ (Name of Notary Typed, Stamped or Printed) Notary Public, State of GeorgiaMy Commission Expires: ______________ Reference44-14-361.5.