Fill and Sign the Texas Notice Retainage Form

NOTICE TO OWNER OF RETAINAGE AGREEMENT-CORPORATION The undersigned corporation, ________________________________ , as a claimant who plans to labor, furnish labor or materials, or specially fabricate materials under an agreement with an original contractor or a subcontractor providing for retainage, and hereby provides to ________________________________ , the owner or reputed owner notice of such retainage agreement, and states the following: (1) The sum to be retained is: ____________________________________________________________________________ . (2) The due date or dates, if known, is/are: _____________________________________________ . (3) A general indication of the nature of the agreement is as follows: ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ . Signed on the _____ day of _______________ , 20 _____ . Signature       Printed Name _____ ________________________________ Title _____ _______________________________ Name of Corporation 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       . Notice to Owner of Retainage Agreement Page 1 of 2 So certified this the _____ day of _______________ , 20 _____ . Signature TX Code § 53.107 Notice to Owner of Retainage Agreement Page 2 of 2