Fill and Sign the Notice of Nonresponsibility Individual Minnesota Form

NOTICE OF NON-RESPONSIBILITY – INDIVIDUAL (M.S.A. § 514.06) COMES NOW, ___________________________________ , a party with an interest in the property undergoing improvements at ______________________________________________________________________ , and would hereby provide Notice of the following: 1. On or about the _____ day of _____________ , 20 _______ , the undersigned discovered that _______________________________ , was providing labor, skill, material, or otherwise contributing to the improvement of said property without the authorization of the undersigned. 2. Pursuant to Minnesota Revised Statute § 514.06, the undersigned hereby provides notice that the undersigned will NOT be held responsible for the costs associated with said improvements and the undersigned’s interest in said property shall not be subject to a lien therefore. 3. This Notice is being given within five (5) days of the discovery of the non- authorized work. This the _____ day of ____________ , 20 ______ . ________________________ Signature _____ ___________________ Type or Print Name Certificate of Delivery I, ___________________________________ , hereby certify that I have delivered this day a true and correct copy of the foregoing to __________________________________ by: ( ) Personal Service ( ) Mailing a true and correct copy of same by certified U.S. mail, postage prepaid, return receipt requested to ___________________________________ , within five (5) days of gaining knowledge of the work or improvement. So certified this the _____ day of _____________ , 20 ______ . ________________________ Signature MN § 514.06