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AFFIDAVIT . OF NON-PAYMENT
STATE OF FLORIDA SS Case No. ~ 7~~~"~ °J!
COUNTY OF SAINT LUCIE
The undersigned, being first duly swom, deposes and says as follows: ~
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1. That (s)he is (Agent for Plaintiff) in Case No.
~ (Attorney for Plaintiff ) . ~
in the Civil Division of County Court of 'nt Lucie County, Florida, wherein
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is (are) Plaintiff (s) and ~ ~ ~
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is (are) Defendant (s) .
2. That said Defendant(s) has (have) failed to make payment of money due said Plaintiff(s)
in the manner provided in the Stipulation hereinbefore filed in this cause.
3. That of the monev stated in said Stipulation to be due said Plaintiff (s) from said Defend-
~t~s~ _ 463.49 damages plus ~------------------costs are now past due
~ and wholly unpaid. -
And further the undersigned saith not.
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Subscribed and sworn to ~
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before me this g~ 31st . `
day of OCTOBER
19?
4.
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