REQUEST BY LIENOR FOR

SWORN STATEMENT OF ACCOUNT

WARNING: YOUR FAILURE TO FURNISH THE REQUESTED STATEMENT SIGNED UNDER OATH WITHIN THIRTY (30) DAYS OR THE FURNISHING OF A FALSE STATEMENT WILL RESULT IN THE LOSS OF YOUR RIGHT TO RECOVER ATTORNEY'S FEES IN ANY ACTION TO ENFORCE THE CLAIM OF LIEN OF THE PERSON REQUESTING THIS STATEMENT.

TO:	________________________________

(Owner's Name)

(Owner's Address)

The undersigned hereby demands a written statement under oath of the amount of all direct contracts, the amount paid by or on behalf of the owner for all labor, services and materials furnished pursuant to the direct contract; the dates and amounts paid or to be paid by or on behalf of the owner for all improvements described in any direct contracts; and the reasonable estimated costs of completing according to the terms and specifications of any direct contract under which construction has ceased for the real property described as (legal description):

Dated: __________________,	.

Lienor

By:

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