REQUEST FOR SWORN STATEMENT OF ACCOUNT

WARNING: YOUR FAILURE TO FURNISH THE REQUESTED STATEMENT, SIGNED UNDER OATH, WITHIN 30 DAYS OR THE FURNISHING OF A FALSE STATEMENT WILL RESULT IN THE LOSS OF YOUR LIEN.

To:

 

Certified Mail-Return Receipt Requested

Re: (Property description)

Dear:

Pursuant to F.S. 713.16(2) the undersigned demands a written statement under oath of his account showing the nature of the labor or services performed and to be performed, if any, the materials furnished, the materials to be furnished, if known, the amount paid on account to date, the amount due, and the amount to become due, if known, as of the date of the statement for the improvement of subject property.

Sincerely,

 

By: _______________________________
(address)
(date)