Notice of Completion

NOTICE OF COMPLETION--INDIVIDUAL

Notice is hereby given that:

1. The undersigned is owner of the interest or estate stated below in the property
hereinafter described, or the undersigned is the owner's agent.

2. The full name of the undersigned is

3. The full address of the undersigned is

4. The nature of the interest or estate of the owner is: in fee.
(If other than fee, strike "In Fee" and insert,
for example, "Purchaser Under Contract of Purchase" or "Lessee".)

5. The full names and full addresses of all persons, if any, who hold interest or
estate with the undersigned such as joint tenants or tenants in common are:

6. The full names and full addresses of the predecessors in interest of the
undersigned, if the property was transferred after the beginning of the work or
improvement:

7. The nature of the improvements to the real property

8. The work of improvement on the property hereinafter described was completed
in accordance with the definition of completion in Arizona Revised Statutes section 33-
993, subsection C. (Fill in the appropriate completion date as defined in Arizona Revised
Statutes section 33-993, subsection C.)

(a) - Date

(thirty days after written final acceptance by governmental body)

(b) - Date

(sixty days after cessation of labor)

9. The name of the original contractor, if any, for such work or improvement is

(if no contractor, insert "none")

10. The street address of the property is

(include both address and city with zip code)

11. The legal description of property described above

(attach exhibit if necessary)

Verification

I, the undersigned, certify that I am the owner, the owner's agent for the property
or another interested party in the property, described in the above Notice, or I certify that
I am the original contractor of the improvements to the real property described in the
above Notice. I have read the foregoing Notice and know and understand the contents
thereof, and the facts stated therein are true and correct. I declare under penalty of perjury
that the foregoing is true and correct.

Executed on the day of , 20 , at Arizona.

(date) (place where signed)

Acknowledgement

State of Arizona

County of

The foregoing instrument was acknowledged before me this day of , by (person).

My Commission Expires:

In order to shorten the lien period pursuant to Arizona Revised Statutes section 33-
993, subsection A, a copy of the notice of completion and a written statement of the
date of recording and the county recorder's record location information shall be
served by certified or registered mail, postage prepaid, to the owner, the original
contractor and all persons from whom the person recording this notice has
previously received a preliminary twenty day notice as prescribed by Arizona
Revised Statutes section 33-993, subsection I.

Notice: Receipt of a notice of completion may alter the time you have to impress and
secure a lien in accordance with Arizona Revised Statutes section 33-993, subsection
A.

AZ § 33-993(E)