DISCLOSURE OF STATUTORY SALES COMMISSION LIEN RIGHTS Dear Property Owner: You are signing a listing agreement, commission agreement, sales contract or other contract (a "brokerage agreement") under which you are agreeing to pay ____________________________ (the "broker") a commission for licensed services provided by the broker relating to the sale or other disposition of your real property identified as follows: The Florida Commercial Real Estate Sales Commission Lien Act, Part III of Chapter 475, Florida Statutes (the "Act"), provides that when a broker has earned a commission by performing licensed services under a brokerage agreement with you, the broker may claim a lien against your net sales proceeds for the broker's commission. The broker's lien rights under the Act cannot be waived before the commission is earned. The undersigned Property Owner hereby acknowledges that on the date indicated below the Property Owner received a copy of this Disclosure of Statutory Sales Commission Lien Rights. DATE: _____________________, 20___ _______________________________________________ Print Name: PROPERTY OWNER: Form 475.703(5) - Lien Disclosure-Sales.doc