Contractor’s Disbursement Disclosure for Residential Construction (Consumer-Owned)
Basic Information
Date:
Owner:
Property:
Project: [include description]
Contractor:
[Lender:]
The following information is required to be provided under section 53.258 of the Texas Property Code in connection with this payment request for construction on the Property. This statement will be furnished by depositing the statement in the United States mail, first class, postage paid, and properly addressed to Owner or by hand delivering the statement to Owner before Contractor receives the requested funds.
A.Bills Paid. The following is a list of bills or expenses for labor or materials used on the Project that have been paid and for which Contractor is requesting payment:
Name and address of subcontractor or supplier:
Description of bill or expense paid:
Amount paid:
|
Repeat above information as needed. |
B.Bills to Be Paid. The following is a list of bills or expenses relating to labor or materials used on the Project that will be paid from the funds requested. This list contains the name and address of each person who subcontracted directly with Contractor and whom Contractor intends to pay from the requested funds.
Name and address of payee:
Description of bill or expense to be paid:
Amount to be paid:
|
Repeat above information as needed. |
[Name of contractor]