Notice Of Claim Of Lien And Proposed Sale Of Vehicle Page 4

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CLERK OF CIRCUIT COURT OF BAY COUNTY, FLORIDA
REPORT OF SALE___
IN: NOTICE OF CLAIM OF LIEN AND PROPOSED SALE OF VEHICLE
DESCRIPTION OF VEHICLE {YEAR, MAKE, MODEL, VIN}
BY: _______________________________________________________________________________ AS LIENOR
NAME OF LIENOR
STATE OF FLORIDA
COUNTY OF ____________
BEFORE ME, the undersigned authority, personally appeared ______________________________________ who, being duly sworn
says that:
1.
He/She is the (lienor) or (agent or attorney for lienor) or (duly authorized corporate officer of representative of lienor)
designated in that certain Notice of Claim of Lien and Proposed Sale of Vehicle, a true copy of which is attached hereto.
2.
On the ____ day of _____________, 20____, commencing at _______AM/PM, at ______________________________, the
above named lienor caused the vehicle described in said Notice of Claim of Lien and Proposed Sale of Vehicle, to wit:
__________________________________________________(year, make, model, VIN) to be sold at public/private sale at
which said vehicle was purchased by __________________________________________________(name)
________________________________________________________(address) for the sum of $________________
3.
Lienor herewith deposits with the Clerk of Circuit Court the sum of $________________, which represents all of the
Proceeds from the sale of the above described vehicle, less the following amounts retained by lienor pursuant to
F.S. 713.585 (6).
$________________________
Labor and services
$________________________
Storage charges
$________________________
Cost of publication
$________________________
Other
$________________________
Total amount retained by lienor
4.
No demand or request for a hearing pursuant to F.S. 713.585 has been made or filed and no such hearing has been held.
5.
This Report of Sale is submitted and filed in compliance with the requirements of F.S. 713.585 (6).
___________________________________
Signature of Affiant
SWORN TO and subscribed before me this ___________ day of ___________________, 20____.
____________________________________
My Commission Expires:
Notary Public
State of Florida
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