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F1.A. ~Y67 LAW• ~ 11AMC01011M 1!O•
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6efon m~, th~ ~ds~si9ned authorih. Personally appearsd.....SeQtCmbCr .20 ~ 1974 _ _ . ;
who, b~in9 duly sworn, says that he is 1h~ lienor heroin or ~ of ~he lierwr herein, ,i
Mitchell E. Rech
.
(Ueno~ s Name)
411 S. Indian River Dr., Ft. Pierce, Florida ,
Mrhose address is......
(Lienor s Address)
and that in pursuance of a contrad wi1h. _William G.....Coo~er.:and or _
K~.YM.1e!Y. _Products... : . . . _ . ,
_ _ . . . .
lienor fumished labor, services or materials consisting of: (Describe specially fabricated materials s~pantely)
Back wages from 1-11-?4 thru 3-1-?4 $900.00
Persona~. car for business - 148.00
Y.ealth Insurance Premiums 304.00
Thirteen..hundied f if ty two ~~an (s 1352_.40 _
of a tota) value oE _ _
oF which fhere remains unpaid S~.~5~•0_Q. _ , for which amount he daims a lien~on the Followin9
destribed real property in. . . _ ._I,UG~1C.. . _ _ . County, Florida:
(Describe rea) propsrty suffiaeNly for ideMification, induding street and number if known)
William G. Cooper individually and Keyway Products F ~~t?R R o
~ 4501 South Federal Highway ~y~~~~~A. ~
~ ~ P91TRA~ ~
~ Fort Pierce, Florida C«f:K ~~~~u1Ta0nRt
P.=C~P.L• YEk:Fl~O~~.
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~ Str 10 2 PM'1+1
29~~,c.0
tYilliam G. Cooper _ . .
_
_
y . .
He further says that lienor Fumished the first of said labor, services or materials on . t.WG~~.~Ct~1.......
UCt.~be= 19?..~.., and 1he last of the same onP,3,tS~. .t~rCb............., 19 7..4, and (if the lien
is da'xrrsd by one not in privity with the owner) that the lienor served his notice to owner on . tweAt.ieth
.September ................,19?4-., by. . . _ . . . .
Met of Service~
_ _ _ _ . . .
~ - lienor
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By _ _ _
A9ent or Attorney
;y _
~ _ _19 7
Sworn to and wbsaibed before ms this........... ......-~.y7- .......day . . .
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