Fill and Sign the Notice Owner Contractor Form

NOTICE TO OWNER OR ORIGINAL CONTRACTOR OF ORDER FOR SPECIALLY FABRICATED ITEMS - INDIVIDUAL The undersigned individual, ________________________________ , as a claimant who has specially fabricated materials for incorporation into a residential construction project hereby provides notice for his or her lien to be valid, not later than the 15th day of the second month after the month in which the undersigned received and accepted the order for the material, to ________________________________ , the owner or reputed owner, and states the following: (1) The specially fabricated materials had not yet been delivered to the property or incorporated in the residential construction project as of _____ day of _____________ , 20 ______ . (2) The order for specially fabricated items has been received and accepted, and the price of the order is ________________________________ . (3) If the indebtedness is incurred by a person other than the original contractor, the undersigned has also provided this notice to the original contractor. Signed on the _____ day of _______________ , 20 _____ . Signature       Printed Name Certificate of Delivery I,       , hereby certify that I have delivered this day a true and correct copy of the foregoing to       by: Mailing a true and correct copy of same by Certified or Registered U.S. Mail, postage prepaid, to       , at his/her last known business or residence address located at       . So certified this the _____ day of _______________ , 20 _____ . Signature TX Code § 53.253 Notice to Owner or Original Contractor Page 1 of 1