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RAMCO FORM 12014
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apP~ VICTOR 06MAN.
- Sa/ore rrte.the tNldersi~ted authorib• personally .
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who, beirq duly sworn. says that IN N the lierlor frerNn a the pent of tha lierlor har•tn.
- ~ - ILierlor's Name1 . -
whose address is.......14~~. Sr...4~..5 4~......... F'~a_. ~~~r~.,. ~irl1.....~~45I?..................... \ , -
ILienor's Address) -
aRd that in punrwnce of a oorltract with......F~iRR..~...1r~T ,
- - _520 20TH STREET FT. PIERCE, FLA -33450 ~ _i
lisrlor famished bbor, servkws or mabrisb cauistinp of: tOescribe specially fabricated materials st+psraulyl,
BODY -SHOP REPAIRED- FRO11T S~1D DAMAGE - .
REPLACED 1 PAD @ 8.85 ~ - -
1 DE~FLSCTOR @ 23.55
1 GRILLS PANEL @ 110.05 - -
1 HEAD LAMP DOOR @ 25.45 - -
- 1-RECHROMB BUMPER @ 88.00 ~ - - -
1 DAYS S GS @ 5.00 A DAY-$105-0(, ~l..~IC1F .............................:....county. Flonda:.
on tM t tl~ propsrq ~ 3
(Describe real property :ufHdertdll for iderttificadon. indudirlp -street and rwmber, if known)
1979 MBRCURY COUGAR -
VEHICLE ID #-98938631383 -
2 DR MAROOt~I - - -
- FRED L. NEST
owned by -
of s total vahre OI~l~'°• HUNDii;$Q: ~?Q$'1'yC_..dN~. ~-.17.«.~_~____..____dOllars llti ~41w~.~ .....................:...t
- of which then remains unpaid is691.17 for which amount M claims a lien on the about - -
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described real property. -
He further says that lienor famished tha fin of said labor. services or materials on ...APRIL.-1.8x1984-•••-•-•--
APRI1. 20 ,198U----.and lif the lien -
• 19----•-----• and thi last of the same on................... _
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served hrs notice to owner on
I is claimed by one not in privity with the owner) that the lienor - AUGUST--29-•••--•-• ~
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0 CERTIFIED MAIL
-.198......... by
i
f _ )Method of Service)
- and, (if the-lien is claimed by one not in privity with the contractor) that the lisnor served a copy of hrs notice to
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~ `owner on
(Contractor) - . 'f
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~ on'•--•--•--• ~ .19.-.•--•---• by-.................... •
i (Method of Service)
and addition_
_ally, (if the lien is claimed by one not in privity with the wbrontractorl-drat the lienor served a Dopy
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~ of his notice to owner on ~ - -
t
4 (Subcontractor)
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~ of Service) -
- - X80 SAP t 9 ~ OS - - 4
[ ~aEe ~?kc F~coar>FO Lienor - I.`'
T.LtICIf COUIt~Y.fiA.
ROGER f
OITRAS QiNER . -
E ~ CLERK CgIWIT COURT
S~ELOADI'f'p{itfil---_.__ .~.~:r..:dy ..................................A9snt•---:................-.-.--.....--•-- i
Swom to and subscribed before me th' ' ~7 : ~s A$SPTEMBER .19.80.: .
.I~CK-........---........
.Notary Pt_ !!e Stale
. • - ~NtOry th~biK. Ot f Li ~a.'st
?'his lnslrnnrrnl prrpar~d b~•. ~ ~i ~g4
:~~~jt~°! ~ ` - ' tasMe'ssioa Expires 1ca• 27.
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