Owner person or entity?

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WARNING! THIS LEGAL DOCUMENT REFLECTS THAT A CONSTRUCTION LIEN HAS BEEN PLACED ON THE REAL PROPERTY LISTED HEREIN. UNLESS THE OWNER OF SUCH PROPERTY TAKES ACTION TO SHORTEN THE TIME PERIOD, THIS LIEN MAY REMAIN VALID FOR ONE YEAR FROM THE DATE OF RECORDING, AND SHALL EXPIRE AND BECOME NULL AND VOID THEREAFTER UNLESS LEGAL PROCEEDINGS HAVE BEEN COMMENCED TO FORECLOSE OR TO DISCHARGE THIS LIEN.

CLAIM OF LIEN

State of ____________________ (state where signed)
County of ___________________ (county where signed)

        Before me, the undersigned notary public, personally appeared , who was duly sworn and says that she or he is the lienor or agent of the lienor herein, whose address is , ; and that in accordance with a contract with , lienor furnished labor, services, or materials consisting of on the following described real property in County, Florida:


owned by of a total value of $0.00, of which there remains unpaid $0.00, and furnished the first of the items on INVALID DATE NAN, NAN, and the last of the items on INVALID DATE NAN, NAN. The lienor served her or his notice to owner on INVALID DATE NAN, NAN. The lienor served copies of the notice on the contractor on INVALID DATE NAN, NAN. The lienor served copies of the notice on the subcontractor on INVALID DATE NAN, NAN.

        

        By: ______________________________
        Print:
        Title:

        The foregoing instrument was acknowledged before me by means of ☐ physical presence or sworn to (or affirmed) by ☐ online notarization this ___ day of _____________, 20___, by who is personally known to me, or has produced _________________ as identification.

                                                                                          Signature:
                                                                                          Printed Name:
                                                                                          NOTARY PUBLIC, STATE OF _______________
                                                                                          Commission Expiration Date:

April 6, 2025

via Regular U.S. Mail
and Certified Mail, Return
Receipt Requested to:
#### Certified No. ####


        Re: Demand for Payment - Claim of Lien

Dear Sir/Madam,

        Please be advised that this law firm represents

         provided labor, services, and materials generally consisting of for the construction improvement of real property located at . At present, there is a principal unpaid balance of $0.00 due and owing for that work. has incurred $0.00 in attorney's fees in its attempt to collect this debt, for which you are liable.

        Demand is made for payment of the full amount due of $0.00 within days of the date of this letter. Please find enclosed a copy of the Claim of Lien that has been submitted to the County Clerk of Court for recording against the property.

        In the event that payment in full is not made, our client has instructed us to take all necessary actions to affect payment of the amount due. This may include filing a lawsuit for foreclosure of the property. If this should occur, you will be held liable for additional interest charges, as well as my client's court costs and attorney's fees.

        PLEASE GOVERN YOURSELF ACCORDINGLY.

                                                                                          Very truly yours,

                                                                                          Raphael D. Rashkin, Esq.

Enclosure

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