LEGEND FOR FILLING IN THE BLANKS

Place of execution. This section at the upper left describes the state and county where the claim of lien is executed. If the construction claim of lien is filled out and sworn to in Marion County, Florida, even though the property being claimed against is in Alachua County, Marion County would be the right name in the upper left hand corner.
Name of person executing lien. The name of the person who actually signs the lien.
Position of person executing lien. If the lienor is Michael Jackson who is claiming a lien as a sole proprietor in his own name, then a designation of capacity is not necessary, but most liens are claimed by business entities such as corporations and as such an agent of the corporation signing the lien should put his title in this blank. For example, if the president of the corporation is signing the lien, he should put president in this blank.
Name of Lienor. This is the name of the company or individual that is filing the lien. Note: When a fictitious name is being used such as ABC Construction, the blank should state John Doe, d/b/a/ ABC Construction, instead of just John Doe.
Address of entity filing claim of lien.
Your customer. The name of the company or individual with whom you contracted or who gave you the order.
Description of labor, services or materials. Just as in the notice to owner, a general description denoting the labor, services or materials must be placed in this blank. (For example, roofing, plumbing, concrete, etc.) Note: when the lien is for specially fabricated materials and they have not been installed into the job site the lien must specify what specially fabricated materials are in issue. (For example, “Specially fabricated cabinets.”)
Countyin which project is located.
Legal description of property. In this space you should put the legal description such as the lot and block and not just an address. This information can be obtained from a notice to owner company, building department or public records of county in which the project is located.
Name of owners. This information can be obtained from a notice to owner company, building department or public records of county in which the project is located.
Total value of labor, services or materials. This is often a source of confusion since this is not where the total contract price is to be put but instead the total value of the labor, services or materials incorporated into the project. However, if there are specially fabricated materials, it will be the total value of all of the materials that have been fabricated for this project.
Amount owing. This space is to be provided with an amount, that represents the total value of labor, services or materials provided to the project unless they are specially fabricated less any payments previously paid. Note: This is not a deduction of payments previously paid from the contract amount but a deduction from the total value incorporated into the project.
Dates the claimant supplied labor, services or materials. These dates are crucial to the enforcement of a construction claim of lien. The first date usually is not difficult to determine. However, the last date may be. The last date should not include punch-out work but instead should include any work in furtherance of completion of the contract.
Dates the claimant supplied labor, services or materials. These dates are crucial to the enforcement of a construction claim of lien. The first date usually is not difficult to determine. However, the last date may be. The last date should not include punch-out work but instead should include any work in furtherance of completion of the contract.
Date of service of notice to owner. This space is to be provided with the date on which the owner received the notice to owner. Generally a notice to owner is timely if it is served within 45 days after the first furnishing of materials or services to the construction project and prior to the contractor presenting the owner with a contractor’s final affidavit and the owner disbursing the final payment. Note: when dealing directly with the owner, a notice to owner is not required.
Return receipt certified mail numbers.
Return receipt certified mail numbers.
Names of witnesses. To record a construction claim of lien, the witnesses to the execution of the document must print or type their names underneath their signatures.
Names of witnesses. To record a construction claim of lien, the witnesses to the execution of the document must print or type their names underneath their signatures.
Name of notary. To record a construction claim of lien in Florida, the notary must print or type their name underneath their signature.
Copies provided to. In this space, the owner’s name and address should be placed along with anyone else receiving a copy of the construction claim of lien. The construction claim of lien should be served on the owner within 15 days of recording.
Name of preparer. Under Florida law any recorded document must have the name of the person that prepared the document on the face of the lien.