Fill and Sign the Notice from Owner to Contractor to Furnish Contractors Final Payment Affidavit Individual Form

Notice from Owner to Contractor Page 1 of 1NOTICE FROM OWNER TO CONTRACTOR TO FURNISH CONTRACTOR’S FINAL PAYMENT AFFIDAVIT- INDIVIDUALTO: ___________________________________ DATE: __________________________________ __________________________________ __________________________________ (contractor's name and address)The undersigned hereby requests that you furnish the Contractor’s Final Payment Affidavit as required under Section 713.06(3)(d)(1), Florida Statutes stating that all lienors under the direct contract who have timely served a notice have been paid in full, or showing the name of each such lienor who has not been paid in full and the amount due or to become due each for labor, services, or materials furnished pursuant to contract for the construction of certain improvements to real property described as __________________________________________________________. __________________________________ (Owner’s signature) Type or Print Name: _____________________________ Address: ______________________________________ Certificate of Service I, _____________________________________, hereby certify that I have delivered this day a true and attested copy of the foregoing to ___________________________________ by: ( ) Actual Delivery to the person to be served. ( )Mailing a true and correct copy of same by registered or certified U.S. mail, with postage prepaid, or by overnight or second-day delivery with evidence of delivery. ( ) If service cannot be made by the above methods, by posting on the premises. ________________________Signature