Sworn Statement of Account
State of Florida Before me, the undersigned authority, personally appeared _____________________, who after being duly sworn deposes and says that regarding the (describe project) the following is true: 1) Nature of labor or services performed and to be performed:
2) Materials furnished and to be furnished:
3) Amount paid on account to date: $
4) Amount due: $
______________________________________
By:__________________________________ The foregoing statement was sworn to or affirmed before me this ___ day of ___________, 20__, by ______________________ on behalf of ________________________________, and who is personally known to me.
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