Fill and Sign the Tn Notice Completion Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ___________________ Company: ____________________ Address: _____________________ City: ____________________ State: ______ Zip: __________ Phone: ___________________ Fax: ____________________ Reference Instrument Number: ________________ This instrument was prepared by: Name: ___________________________________ Address: _______________________________________________________________ NOTICE OF COMPLETION--CORPORATION (Tenn. Code Ann. § 66-11-143) COMES NOW, ___________________________________ , as the representative of __________________________________ a ___________________________________ corporation and would hereby provide notice of the following: 1. The legal name of the owner or owners of the real property is/are: ____________________________________________________________ . 2. The names of all applicable prime contractors are: ____________________________________________________________ . 3. The location and description of the real property is: ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________ . 4. The date of completion of the entire improvement was the _____ day of _______________ , 20 ______ . 5. A transfer of ownership of all or a part of the real property or an interest therein and encumbrance thereon or a settlement of the claims of parties entitled to the benefits of Title 66, Chapter 11 of the Tennessee Code Annotated will take place not less than ten (10) days after the date of the recording of this notice of completion; provided, that the ten-day expiration for lien claimants shall only apply to contracts for improvement to or on real property for one-family, two-family, three-family and four-family residential Notice of Completion Page 1 of 3 units. On all other contracts for improvement to or on real property, the expiration time for lien claimants shall be thirty (30) days after the date of the recording of this notice of completion. The name and address of the person, firm or organization on which parties entitled to the benefits of Title 66, Chapter 11, may service notice is as follows: Name: ___________________________________ Street Address: __________________________________________________________ City: _________________________ State: _______________ Zipcode:. ___________ This the _____ day of _____________ , 20 ______ . _________________________________ Signature (check one) Owner Purchaser Prime Contractor _____ ____________________________ Type or Print Name _____ ____________________________ Title _____ ____________________________ Corporation Attest: Secretary STATE OF TENNESSEE COUNTY OF _______________ Personally appeared before me, the undersigned, a Notary Public within and for said State and County aforesaid, duly commissioned and qualified, ___________________________________ of the state and county mentioned, personally appeared ___________________________________ , with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence), and who, upon oath, acknowledged such person to be president (or other officer authorized to execute the instrument) of ___________________________________ , the within named bargainor, a corporation, and that such president or officer as such __________________________________ , executed the foregoing instrument for the purpose therein contained, by signing the name of the corporation by himself/herself as such officer. Witness my hand and seal, at office in _____ , this __________ day of ______ . Notice of Completion Page 2 of 3 Notary Public My commission expires:       Type or Print Name Notice of Completion Page 3 of 3