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II ss~~~a.oe ~ ! ? • ' (~l~ttnt ~t~ert ~ ~ ~ l ` aa ~ , _ ( ~a 8sfor~ ms, th~ undeni9nsd aulhority. Pe~sonally appearad~.- . . _ " ' ~ the agent 1 who, b~in~ duly sworn, says ttiat he is ths lienor herein or ; th~ a~torney `°f ~he lienor herein, , . . t . . . . (lienoi s Name) ~ . , . ~ _ . . . . ~ . • ~ . . _ . _ . _ _ . . , whose eu ~s . . (lienor s Add~ess) _ ~ . • _ ~ ~ T . . - . . , , and that in purwanoe of a coMrad with . . . . . . , ~ ' . _ ? _ ' - . . ~ , ~ . ~ ~ ~ ~ ~ ~ , . lieno~ fu~nished labor, services or materials consisti~y oF: (Describe specially Fabricated materials separately) -W . ~ of a total value of-......-.. _ _ . . _ . _ dollars (s ) of which there remairu unpaid S - for which amounl he daims a lien on the following desvibed real properfy in . . . _ . . . _ . . _ . _ County, Florida: . (Desaibe reai property wfFidently for idenlificatio~, induding street and number if known) _ - - . - ~ • - ~ - , - ~ , . FtIEU t~:=: =.cG73JE8 - - SLlbC1: GJ~MIY fl~ - fi~ _ ' - :;)17RAS I ~c ~r ~~:K .^C~t~ CdU4T ~ ~ . `f R ,1u~ i b 9 3s QH . - o~ b,? . : ~ _ . . : . _ . .~86;~ _ He Further says that lienor fumished the Firs1 of said labor, services or materials on ~ - - I . _ 19.._..._.., and the last of the same on 19 , ar?d (if the lien is daimed by one not in privity vvith the owner) ihat the lienor served his notice b owner on . . - - 19-....-~--, by. _ _ , ~ u (Method of Service) ~ ~ ~ . ~ ~s~ ~ ' ~ J ~ `lienor ` ..7 ~ ~ , J,• ' ~ V ~ ~ ~y,~~n~ ~ • ' i~ " r. C~ # . . . . . ~ , gy : ' . ~ ' ~ . Agent w Attorney _ o c: ~ ?y : . ~ _ ~ i ~ . ~ ` _ _~9 ~ _ .....da of _ ~ Swom to and wbscnbed bsfore ms this . y ~ ~ .•~`~t:~tt~i~~~~r ` . _ ~ ` ; _ ~ - _ ~ ~ ~ , - . ~ . _ _ . ~ ~ . ~ . . l ~ ' Ne+or r'~ii~, f~r~ tl.di ~ • ~ ~ ~ ~ : ~ ~I~.-=.P ~ .1~--.-~~. , ~ = ~ ~ r+~r c«.ri,~+.~ s~r~ a~, tv~a ~ - ; : Notary u ic - io^dsd b! AwaicM Hr~ • Cmwlh G~. i~ G = ~ ' .<f ' . . ~ ~~•''1 r. 'Ir - 1 ~ j_ . - l7it~ /~is~rti~n~~?rl ~~rr~airrrl 1~~~- L _ • . ~~~i~~r:H . ~ _ - - - ~ ~ . - ~ - . t - - BCQf( ~~?~~7 PACf ~ ~ - - - - - - - - . . . ~:3. _ ~ ~ '