Fill and Sign the Notice Commencement 497302786 Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ___________________ Company: ___________________ Address: _____________________ City: __________________________ State: _____ Zip: _____________ Phone: _____________________ Fax: _______________________ Permit No. ____________________ Tax Folio No. _______________________ NOTICE OF TERMINATION OF NOTICE OF COMMENCEMENT- INDIVIDUAL THE UNDERSIGNED hereby informs all concerned that the undersigned will TERMINATE that certain Notice of Commencement dated _____ day of _________________ , 20 _____ , that is recorded in Official Record Book __________ , Page __________ , of the Public Records of _________________ County, Florida, and in accordance with Section 713.132, Florida Statutes, the following information is provided: 1. The date and recording information concerning the Notice of Commencement being terminated is as described above. 2. A copy of the Notice of Commencement is attached hereto and all information contained therein is hereby expressly incorporated into this Notice of Termination. 3. The Notice of Commencement shall be terminated as of _____ day of ______________ , 20 _____ . If no date is inserted in the preceding blank, the Notice of Commencement will be terminated thirty (30) days from the date that this Notice of Termination is recorded. 4. This Notice of Termination is effective as to all property described in the Notice of Commencement unless a legal description is set forth below this paragraph (in which case the termination is effective only as to the property described). Notice of Termination of Notice of Commencement Page 1 of 3 5. All lienors have been paid in full or prorata in accordance with Section 713.06(4), Florida Statutes. 6. Attached is a Contractor's Affidavit upon which the undersigned has relied. 7. The undersigned has, before recording this Notice of Termination, served a copy of this Notice to the contractor listed in the Notice of Commencement, and to each lienor who has served a Notice To Owner. Signature of Owner _________________________ Owner's Name _____ ________________________ Owner's Address _____ ______________________ STATE OF ___________ COUNTY OF _____________ Sworn to (or affirmed) and subscribed before me this _____ day of _________________, 20______ by _________________________ (name of person making statement) who is personally known to me or produced _________________________ as identification, and who did take an oath. ____________________________ NOTARY PUBLIC Printed Name of Notary _________________________ Commission Expires _________________________ Verification Pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. ______________________________________ (Signature of Natural Person Signing Above) Certificate of Service Notice of Termination of Notice of Commencement Page 2 of 3 I, _____________________________________, hereby certify that I have delivered this day a true and attested copy of the foregoing to the contractor and on each lienor who has given notice by: ( ) Actual Delivery to the person to be served. ( ) Mailing a true and correct copy of same by registered or certified U.S. mail, with postage prepaid, or by overnight or second-day delivery with evidence of delivery. ( ) If service cannot be made by the above methods, by posting on the premises. ________________________ Signature Notice of Termination of Notice of Commencement Page 3 of 3