(1) A lien notice made by a broker with respect to a commission claimed under this part shall be in writing, shall be signed and sworn to or affirmed by the broker under penalty of perjury before a notary public, and shall include the following:
(a) The name of the owner of the commercial real estate who is obligated to pay the claimed commission.
(b) A statement whether the owner obligated to pay the commission is the landlord or the tenant under the lease for which the commission is claimed.
(c) The name of the person owning the fee simple interest in the commercial real estate, if other than the owner obligated to pay the commission.
(d) The legal description of the commercial real estate.
(e) The name, mailing address, telephone number, and license number of the broker.
(f) The effective date of the brokerage agreement.
(g) The amount of the commission claimed by the broker, which may be stated in a dollar amount or may be stated in the form of a formula determining the amount, such as a percentage of the rents payable under the lease.
(h) A description of the lease sufficient to identify the lease for which the commission is claimed, including, if then known to the broker, the names of the landlord and tenant under the lease, the date of the lease, and the identification of the leased premises.
(i) A statement of whether the broker is claiming an automatic renewal commission and the amount of such automatic renewal commission or the formula for computing the same.
(j) A statement under penalty of perjury that the broker has read the lien notice, knows its contents, believes the same to be true and correct, and makes the commission claim pursuant to the brokerage agreement described in the lien notice.
(2) A lien notice in substantially the following form shall be sufficient for purposes of subsection (1):
BROKER’S COMMISSION LIEN NOTICE
UNDER FLORIDA COMMERCIAL REAL ESTATE
LEASING COMMISSION LIEN ACT
Notice is hereby given, pursuant to the Florida Commercial Real Estate Leasing Commission Lien Act, part IV of chapter 475, Florida Statutes (the “act”), that the undersigned real estate broker is entitled to receive a leasing commission from the owner named below pursuant to the terms of a written brokerage commission agreement regarding a lease of the commercial real estate described below, and the undersigned broker claims a lien under the act against the owner’s interest in the commercial real estate in the amount set forth below.
1. Name of the owner who is obligated to pay the commission:
2. (Check one:) The owner obligated to pay the commission is:
[ ] the landlord under the lease.
[ ] the tenant under the lease.
3. Name of the person owning the fee simple interest in the commercial real estate, if other than the owner who is obligated to pay the commission:
4. Legal description of the commercial real estate:
5. Name, mailing address, telephone number, and Florida broker license number of the undersigned broker:
6. Effective date of the written brokerage commission agreement between the owner and the broker under which the commission is or will be payable: , .
7. Amount of commission claimed by the undersigned broker:
$ , or percent of rents payable under lease, or
[specify other formula for determination of commission amount]:
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: ,
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 and sworn to or affirmed under penalty of perjury before me, a notary public, this day of , ,
Signed: (notary public)