Fill and Sign the Texas Mechanics Form

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 CONFIDENTIALITY RIGHTS: IF YOU ARE A NATURAL PERSON, YOU MAY REMOVE OR STRIKE ANY OF THE FOLLOWING INFORMATION FROM THIS INSTRUMENT BEFORE IT IS FILED FOR RECORD IN THE PUBLIC RECORDS: YOUR SOCIAL SECURITY NUMBER OR YOUR DRIVER’S LICENSE NUMBER. AFFIDAVIT OF COMPLETION--INDIVIDUAL STATE OF __________________ COUNTY OF ________________ 1. I/We ________________________________________________ am/are the owner(s) of the improved real property and reside at ____________________________________ in the City of _________________ , State of _________________ . 2. ________________________________________ was the original contractor for the improvements and his/their address is             . 3. The improved property is located at: ____________________________________ in the City of ________________ , Texas. The legal description of the real property is: [Insert or attach as Exhibit A]                         4. Under the original contract, the following improvements have been completed:       Affidavit of Completion Page 1 of 3             5. The improvements under the original contract were completed on the ____ day of _______________ , 20 ____ . 6. NOTICE: A CLAIMANT MAY NOT HAVE A LIEN ON RETAINED FUNDS UNLESS THE CLAIMANT FILES THE AFFIDAVIT CLAIMING A LIEN NOT LATER THAN THE 30TH DAY AFTER THE DATE OF COMPLETION. Subscribed and sworn to this _____ day of ________________ , 20 ____ , at __________________ , __________ . Signature and Acknowledgment of Individual Claimant       Doing Business as       STATE OF TEXAS COUNTY OF __________________ This instrument was acknowledged before me on ___________________ (date) by (name or names of person or persons acknowledging) . Notary Public       Printed Name My Commission Expires:       Certificate of Delivery I, ____________________________________ , hereby certify that I have delivered this day a true and correct copy of the foregoing to _______________________ by: Hand Delivery Mailing a true and correct copy of same by U.S. mail postage prepaid to _________________________ , at his usual place of business located at       . So certified this the _____ day of ____________________ , 20 ____ . Affidavit of Completion Page 2 of 3 Signature TX Code § 53.106 Affidavit of Completion Page 3 of 3