Fill and Sign the Florida Notice Contest Lien Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: ___________________ Company: ___________________ Address: _____________________ City: __________________________ State: _____ Zip: _____________ Phone: _____________________ Fax: _______________________ NOTICE OF CONTEST OF LIEN- CORPORATION or LLC TO: _________________________ _________________________ _________________________ (name and address of lienor) YOU ARE NOTIFIED that the undersigned contests the Claim of Lien filed by you on ___________________ , 20 _____ , and recorded in Official Record Book ________ , Page __________ , of the Public Records of _________________ County, Florida, and that the time within which you may file suit to enforce your lien is limited to 60 days from the date of service of this notice. DATED ON _____ , day of ________________ , 20 _____ . Signature of Owner or Attorney _________________________ Printed Name of Owner or Attorney ______________________ Name of Company ______________________ Address ______________________ ______________________ Attest: Secretary Notice of Contest of Lien Page 1 of 2 ALL INFORMATION MUST BE TYPED OR PRINTED LEGIBLY TO COMPLY WITH RECORDING REQUIREMENTS. A copy of this Notice of Contest of Lien has been mailed to the lienor at the address shown in the above - described Claim of Lien on this __________ day of ________________, 20____. CLERK OF THE CIRCUIT COURT By: ____________________________ As Deputy Clerk (COURT SEAL) STATE OF FLORIDA COUNTY OF _____________________ The foregoing instrument was acknowledged before me this _____ day of ________________, 20_____, by ________________________________ (name of person acknowledging) as _____________________ (type of authority, e.g. officer, trustee, attorney in fact) for ________________________________ (name of party on behalf of whom instrument was executed) who is personally known to me or who has produced ____________________________ (type of identification) as identification. ______________________________ Notary Public Printed Name:__________________ My Commission Expires: ___________________________ Notice of Contest of Lien Page 2 of 2