Section 880.340.

Subject to all statutory requirements for recorded documents, a notice of intent to preserve an interest in real property shall be in substantially the following form:

RECORDING INFORMATION
Recording requested by:				FOR USE OF COUNTY RECORDER
After recording return to:				Indexing instructions. This notice must be indexed as follows: Grantor and grantee index—each claimant is a grantor.
NOTICE OF INTENT TO PRESERVE INTEREST
This notice is intended to preserve an interest in real property from extinguishment pursuant to Title 5 (commencing with Section 880.020) of Part 2 of Division 2 of the Civil Code (Marketable Record Title).
Claimant		Name:
		Mailing address: (must be given for each claimant)
Interest		Character (e.g., power of termination): Record location of document creating or evidencing interest in claimant:
Real Property		Legal description (may be same as in recorded document creating or evidencing interest in claimant):
I assert under penalty of perjury that this notice is not recorded for the purpose of slandering title to real property and I am informed and believe that the information contained in this notice is true. If this notice is made on behalf of a claimant, I assert under penalty of perjury that I am authorized to act on behalf of the claimant.
Signed:	(claimant) (person acting on behalf of claimant)		Date:
Certificate of acknowledgment required.

(Amended by Stats. 2012, Ch. 94, Sec. 1. Effective January 1, 2013.)