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--.r _ - - - - . - _'w.:~t~.lr..i.a..v~+~~ >>R. -_..+S.M.-...i4./ i-~ rw.~~' iii. ' rr... _~.i~ri~,~
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nor ~t»s MMCO fO11M 12014
uw uw. ss ram
fit ~ ~n
.
6efon m.. th. urld«elpn«I•uawriey. p.reonaily app..r.a
who. bs~rp duly swonl, says that M b the lierar hereto a the agent of tM lienor herein.
............~8..tRg..~?G
IUetlor's Nan1e1
b.,...1412 SOUTH FOURTH 3TRSBT .FT. PIBRCB, FLA 33450
. . .
(ftierlor's 1lddressl -
and tflat in punluanw of a contract with..........I.lIRRY..B~lKRR •
............1L7...B8DFD~8A..DBIVS....FT.....PISB~S..FI.A.....33GSD .
iienor furr~lssd s+exvicea or materials consisdrlp of: (Oeecribe specially fabricated materiab separately)
TOWED CAA INTO SHOP-$15.00
2.2 HOURS LABOR @16.00-$35:20 Tax @ 8.25
Parts-Starter @ 38.35 ~ Storage Charges to February. l9, 1980-$252
Battery @ 92.50 Miscellaneous Charges of this action
- Relay @ 5.75 Claim of Lein-$4.00
Cables @ 16.50 Ne~rspaper Ad -$45.00
3 Gal Gaa @ 3.00
on tlN foibwing despibed real property in .............51'a..1.UCx~....................................................County, Fkxida:
(Describe real property wffkiendy for identification, indudirlg street and number. if known)
1968 Lincoln Continental
• VIN-8Y81B801582
2 Dr.-Light Green -
License-# ELG 618.
owned by.......I.arrg.-Baker
of a total valor of F~4Ve.. h~~~g~..~i~~~~~n..~ ..55/_199---------dollars It ..51~.5.5
of which there remains onpsid i. 515.55 ~ amount hs claims a lien on the above
described real property.
He further says that tienor fumishsd the first of said Isbor, services or materiab on A~ctober..25
.18..74-.., and tM last of the same on....Qctobex..25............. • 18...~g., and (if the lien
is claimed by one not in privity with the owner) that the lisnor served his notice to owner on December 5
.
-•,1879-...-. by.. ,certified letter
(Method of Service)
and, (if the lien is claimed by one not in privity with the oontractorl that the lienor served a copy of his notice to
owner on N/.A
)Contractor)
on ........................................................18......:..., by..........................................:................................ ,
)Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on ......._..N~A
ISubcontractorl
on ,18.........., by.................------............................................----.... .
X80 l:EB 18 P!4 ~ 39 (Method of Service)
FItE01?NC FFCUr.Ut fl ...........1~aTk1£..l{RXf~X8...1nC
S R06E~
POITRAga~
p.ERK CIRCtIIt COUP.j Q' ~~r
!~40RD VERtftED_.. ~ 8y
Agent 1u1u~u~1.
Sworn to and subscribed before ms this_..f ifYeEnLh_..._ y of F.ebr g ~.~i8;. , .
Notary Pt~lic - n • ` = •a st''
This Inslrum~•ni prrparrd b~•: ~ ~
t/:l mss 3rs. T7, , j ~ !`tit;
"A~ ~p
e^ Cal!t: Lr~ i~J iir. i-.. It _ •:~!e`_ RC _.1