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CLAIM OF LIEN
24~531
STATE OF FLORIDA
COUNTY OF MARTIN
BEFORE ME, the undersigned authority, personally appeared
E.E. ROGERS , who, being duly sworn, says that he
is (the lienor herein) (the agent/attorney of the lienor herein)
whose address is 508 Colorado Avenue, Stuart, Florida 33494
and that ~n pursuance of a contract with RTC~T.
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(Describe specially fabricated materials separately)
on the following described property in
County, Florida ~ ~
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Describe property sufficiently for identification and give
street address if avaiZable)
owned by~~
of a total value of $ 135.00 , of which there remains un-
paid $ 135_~n and furnished the first of the same on ~,t.~,~.,~,,.
6 , 19 72 and the last of the same on ~ bt.~~
8' , 19~3 _ and (if the lien is claimed by one
not in privity with the owner) that the lienor served his notice
to owner on , 19 by (here described
method of servi.ce of notice
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E. E. ROG~ , Lienor
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~ Qr~ror~ to and subscribed before me
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