Fill and Sign the Notice Commencement Form 497311316

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ____________________ Company: ____________________ Address: ______________________ City: _______________________ State: _____ Zip: __________ Phone: ________________ Fax: __________________ NOTICE OF COMMENCEMENT—RESIDENTIAL PROPERTY--INDIVIDUAL (M.S.A. § 570.1108a) WARNING TO HOMEOWNER Michigan law requires that you do the following: 1. Complete and return this form to the person who asked for it 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. You are not required to but should do the following: 1. Complete and post a copy of this form at the place where the improvement is being made, even if you live there. 2. Make and keep a copy of this form for your own records. To lien claimants and subsequent purchasers: Take notice that work is about to commence on an improvement to the real property 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 accordance 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 subsequently acquiring an interest in the land described is not required to be named in a claim of lien. Notice of Commencement – Residential Property Page 1 of 3 A copy of this Notice with an attached form for Notice of Furnishing may be obtained upon making 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, 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 contracting for the improvement is: Name: __________________________________ Address: __________________________________ Capacity: __________________________________ The name and address of the Fee Owner of the real property, if the person contracting for the improvement is a land contract vendee or lessee, is: 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 improvements to the property) ____________________________________________ Owner or Lessee By_______________________________________ (Signature and capacity of person signing) _____ _______________________________________ Notice of Commencement – Residential Property Page 2 of 3 Type or Print Name 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 A NOTICE OF FURNISHING HERE TO Prepared By: Name: _______________________________________________ Address: ____________________________________________ Notice of Commencement – Residential Property Page 3 of 3