Fill and Sign the Texas Owner 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 COMMENCEMENT—CORPORATION STATE OF TEXAS COUNTY OF             , Owner, whose address is       __________ , and/or       ____________________ , Original Contractor, whose address is       , hereby gives notice that: 1. The following is the name and address of each original contractor, known at the time to the owner, who is furnishing labor, service, or materials for the construction of improvements: Contractor Address                                     2. A description, legally sufficient for identification, of the property being improved is: [Insert legally sufficient property description] Affidavit of Commencement Page 1 of 4                   3. The date the work actually commenced is the _____ day of _______________ , 20 ____ . 4. A general description of the improvement is:                   Signature and Acknowledgment of Corporate Owner By:       Print Name:       Its:       Title Signature and Acknowledgment of Corporate Original Contractor By:       Print Name:       Its:       Affidavit of Commencement Page 2 of 4 Title Attest: Corporate Secretary Print Name:       STATE OF TEXAS COUNTY OF       This instrument was acknowledged before me on ______(date)______ by (name of officer) , (title of officer) of (name of corporation acknowledging) a (state of incorporation) corporation, on behalf of said corporation. Notary Public       Printed Name My Commission Expires:       Affidavit of Commencement Page 3 of 4 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/her usual place of business located at       . So certified this the _____ day of _______________ , 20 ____ . Signature TX Code § 53.124 Affidavit of Commencement Page 4 of 4