Fill and Sign the Florida Bond Construction 497302801 Form

Prepared By: Name ___________________________________ Address ________________________________________________________ NOTICE OF BOND- CORPORATION TO: _____________________________________ DATE: ________________________ _________________________________________ _________________________________________ (lienor's name and address) YOU ARE NOTIFIED that the claim of lien filed by you on the _____ day of ____________________ , 20 _____ , and recorded in Official Records Book ___________ at Page __________ of the Public Records of _______________ County, Florida, is secured by a bond, a copy being attached hereto. Signed ______________________________ (person recording notice) Printed Name _____ ______________________ Title ___________________________ For _____ _____________________________ (name of owner or contractor) Name of Corporation _____ ________________ Address ________________________________ STATE OF ___________ COUNTY OF _____________ Sworn to (or affirmed) and subscribed before me this _____ day of _________________, 20______ by _________________________ (name of person making statement) who is personally known to me or produced _________________________ as identification, and who did take an oath. ____________________________ NOTARY PUBLIC Printed Name of Notary _________________________ Commission Expires _________________________ Verification Pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. Notice of Bond Page 1 of 2 ______________________________________ (Signature of Natural Person Signing Above) A copy of this Notice of Bond has been mailed to the lienor at the address shown in the Claim of Lien on this __________ day of ________________, 20____. CLERK OF THE CIRCUIT COURT By: ____________________________ As Deputy Clerk (COURT SEAL) Notice of Bond Page 2 of 2