Fill and Sign the Notice of Commencement Indivdiual Form

Notice of Commencement Page 1 of 2Prepared by, recording requested by and return to:Name: ________________________Company: ______________________Address: ______________________City: _________________State: _____ Zip: _________Phone: _________________Fax: ________________----------------------Above this Line for Official Use Only--------------------- NOTICE OF COMMENCEMENT-INDIVDIUAL (S.D. Codified Laws Ann. § 44-9-50) COMES NOW, _________________________________, of the following address ____________________________________________________________________________, as a party who is supplying labor and/or materials, under direct agreement with the property owner or his agent, for the improvement of the property located at and described as ______________________________________________________________________________________________________________________________________________________, and would state as follows:1.On or about the _____ day of ______________ , 20_______ the undersigned commenced the furnishing of labor or materials for the improvement of the above described property.2.The above-described property is owned or is being developed by _________________________________, of the following address __________________________________________________________________________.3.A general description of the improvement is as follows: ____________________________________________________________________________ ___________________________________________________________________________. This the _____ day of _____________, 20________ . ____________________________Signature ____________________________ Type or Print Name Notice of Commencement Page 2 of 2State of South DakotaCounty of __________________On this ______ day of __________________ , 20______, before me, ______________________________, the undersigned officer, personally appeared ______________________________, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained.In witness whereof I hereunto set my hand and official seal.Notary Public, State of My commission expires: Type or Print Name