DIY Legal Forms

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Notice Of Non Responsibility

Recoding Requested By:

When recorded mail to:




(Street Address)


(City / State / Zip)


Space above this line for recorder's use

Notice Is Hereby Given That:

1. The undersigned is an owner of the interest or estate stated below.

2. The full name of the owner is ____________________________

3. The full address of the owner is __________________________

4. The nature of the interest or estate of the owner is: in fee. ________

5. The full names and full addresses of all co-owners, if any, who hold any title or interest with the undersigned in the property are: ______________

6. The name of the purchaser under contract, if any, is _______________________

7. The name of the lessee, if any, is _________________________________________

8. The undersigned will not be responsible for any claims arising from the work of improvement on the herein described property.

9. The street address of said property is _____________________________________

10. The property subject to the said work of improvement is in the City of ____________ County of ___________ State of ______, and is described as follows:

Date: ___________________


I _________________________, undersigned, say:

I am _____________________ the _____________________

(President, Agent, etc.) owner of the aforesaid interest or estate in the property described in the above notice; I have read the foregoing notice and know and understand the contents thereof, and the facts stated herein are true and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ______________,20 ___, at ___________(City), _________________

(State) ____________________________.