IN THE COUNTY COURT IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT IN AND FOR ___________________ COUNTY, FLORIDA ______________________ DIVISION ) ) ) ) ) ) ) ) ) ) ) ) , Plaintiff(s), -vs- Case No. Judge , Defendant(s). STATEMENT OF CLAIM (FOR WORK DONE AND MATERIALS FURNISHED) Plaintiff (s), Defendant(s), , sue(s) , and allege(s): There is now due, owing, and unpaid from Defendant(s) to Plaintiff(s) $ with interest since , for the following items of labor and materials furnished to Defendant(s) at his/her (their) request between , and (list time and materials, showing charges therefor and any credits): WHEREFORE, Plaintiff(s) demand(s) judgment for damages against Defendant(s). Attorney or Plaintiff(s) Firm/Address Phone/fax Florida Bar No. Statement Of Claim For Work Done And Materials Furnished {7.332} American LegalNet, Inc. www.USCourtForms.com