Brokers Commission Lien Notice Under Florida Commercial Real Estate Page 2

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8. The lease for which the commission is claimed is described as follows [provide all information known
to the broker]:
Name of landlord: ________________________________________________________________________
Name of tenant: _________________________________________________________________________
Date of lease: _______________,_________
Leased premises: _________________________________________________________________________
9. Automatic renewal commissions (check yes or no): Is the undersigned broker claiming a commission
that may become payable if the lease is later renewed or modified to expand the leased premises or to
extend the lease term, but the written brokerage commission agreement does not expressly require the
broker to perform any additional services in order to receive this later commission?
Yes
No
If yes, specify the amount of such later commission or the formula for computing the later commission:
_________________________________________________________________________________________
10. The expiration date of this lien notice is 2 years after the date of recording, unless the answer to
paragraph 9 is yes, in which case the expiration date of this lien notice for the commission described in
paragraph 9 is 10 years after the date of recording.
11. The undersigned broker, under penalty of perjury, hereby swears or affirms that the undersigned
broker has read this lien notice, knows its contents and believes the same to be true and correct, and
that the undersigned broker is making this commission claim pursuant to the written brokerage
commission agreement described in this lien notice.
Signed:_________________________________________ (broker)
Signed and sworn to or affirmed under penalty of perjury before me, a notary public, this
__________ day of _________________________, ____________________.
Signed:
_________________________________________
(notary public)

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