Lien Search Request Form

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CITY OF HAINES CITY, FLORIDA
LIEN SEARCH REQUEST FORM
QUESTIONS ABOUT THIS LIEN SEARCH?
Please call Code Enforcement at (863) 421-9937 for assistance.
IMPORTANT NOTICE
The requesting party assumes all responsibility for the accuracy and completeness of the property description
information provided to the City, including the property identification number, property address, and legal description.
Note that property identification numbers can have more than one corresponding address, and all relevant addresses
must be listed.
Date of This Request:
Requesting Party’s Name:
Company Affiliated With:
Address:
City, State, Zip Code:
Best Daytime Phone Number to Reach You:
Fax Number:
Email Address:
Mail
Fax
How do you want the City’s Lien Search
Report delivered to you?
Email
Property Address to be Searched:
Property Identification Number:
Legal Description:
Owner of Record:
File Number:
SIGNATURE
I hereby request that the City conduct a search of outstanding liens and assessments on the property cited above. I
have paid the non-refundable lien search fee of $50; 3-5 business days or $100; 1-2 business days. I assume all
responsibility for the accuracy and completeness of the property description information I have provided above. I
understand that performance of the lien search by the City of Haines City will not relieve the requesting party from the
responsibility of searching the public records of Polk County, Florida, for any and all liens or other documents recorded
by the City of Haines City, Florida against the property and/or property owner. The City reserves the right to release
the results of the lien search contingent on bank clearance of payments made by check.
Signature: ___________________________________ Printed Name: ___________________________________

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