Polk County Request for a Sworn Statement of Account Form (Florida)
All Polk County specific forms and documents listed below are included in your immediate download package:
Request for a Sworn Statement of Account Form

Fill in the blank form formatted to comply with all recording and content requirements.
Included Polk County compliant document last validated/updated 6/16/2025
Request for a Sworn Statement of Account Guide

Line by line guide explaining every blank on the form.
Included Polk County compliant document last validated/updated 6/26/2025
Completed Example of the Request for a Sworn Statement of Account Document

Example of a properly completed form for reference.
Included Polk County compliant document last validated/updated 5/12/2025
The following Florida and Polk County supplemental forms are included as a courtesy with your order:
When using these Request for a Sworn Statement of Account forms, the subject real estate must be physically located in Polk County. The executed documents should then be recorded in one of the following offices:
Clerk of Circuit Court - Official Records
255 N Broadway Ave, Bartow, Florida 33830
Hours: 8:00am - 5:00pm M-F
Phone: (863) 534-4516
Mail to: Clerk of Circuit Court - Official Records
P.O. Box 9000 Drawer CC-8 , Bartow, Florida 33831
Hours: for mailing purposes
Phone: N/A
Northeast Branch - NE Polk Co. Gov. Center
3425 Lake Alfred Rd, Winter Haven, Florida 33881
Hours: 8:00am - 5:00pm M-F
Phone: (863) 401-2400
Lakeland Branch
930 E Parker St, Rm 240, Lakeland, Florida 33801
Hours: 8:00am - 5:00pm M-F
Phone: (863) 603-6412
Local jurisdictions located in Polk County include:
- Alturas
- Auburndale
- Babson Park
- Bartow
- Bradley
- Davenport
- Dundee
- Eagle Lake
- Eaton Park
- Fort Meade
- Frostproof
- Haines City
- Highland City
- Homeland
- Indian Lake Estates
- Kathleen
- Kissimmee
- Lake Alfred
- Lake Hamilton
- Lake Wales
- Lakeland
- Lakeshore
- Loughman
- Mulberry
- Nalcrest
- Nichols
- Polk City
- River Ranch
- Waverly
- Winter Haven
How long does it take to get my forms?
Forms are available immediately after submitting payment.
How do I get my forms, are they emailed?
Immediately after you submit payment, the Polk County forms you order will be available for download directly from your account. You can then download the forms to your computer. If you do not already have an account, one will be created for you as part of the order process, and your login details will be provided to you. If you encounter any issues accessing your forms, please reach out to our support team for assistance. Forms are NOT emailed to you.
What does "validated/updated" mean?
This indicates the most recent date when at least one of the following occurred:
- Updated: The document was updated or changed to remain compliant.
- Validated: The document was examined by an attorney or staff, or it was successfully recorded in Polk County using our eRecording service.
Are these forms guaranteed to be recordable in Polk County?
Yes. Our form blanks are guaranteed to meet or exceed all formatting requirements set forth by Polk County including margin requirements, content requirements, font and font size requirements.
Can the Request for a Sworn Statement of Account forms be re-used?
Yes. You can re-use the forms for your personal use. For example, if you have more than one property in Polk County that you need to transfer you would only need to order our forms once for all of your properties in Polk County.
What are supplemental forms?
Often when a deed is recorded, additional documents are required by Florida or Polk County. These could be tax related, informational, or even as simple as a coversheet. Supplemental forms are provided for free with your order where available.
What type of files are the forms?
All of our Polk County Request for a Sworn Statement of Account forms are PDFs. You will need to have or get Adobe Reader to use our forms. Adobe Reader is free software that most computers already have installed.
Do I need any special software to use these forms?
You will need to have Adobe Reader installed on your computer to use our forms. Adobe Reader is free software that most computers already have installed.
Do I have to enter all of my property information online?
No. The blank forms are downloaded to your computer and you fill them out there, at your convenience.
Can I save the completed form, email it to someone?
Yes, you can save your deed form at any point with your information in it. The forms can also be emailed, blank or complete, as attachments.
Are there any recurring fees involved?
No. Nothing to cancel, no memberships, no recurring fees.
What is a request for a sworn statement of account?
Under section 713.16 Fla. Stat. (2016), a statutory Request for a Sworn Statement of Account is used by property owners in response to a notice of intent to place a lien on the owner's property.
The request is addressed to the lienor and contains a description of the owner's property, the name of the contractor, and the name of the lienor's customer (if different from the owner). The form is then signed and dated by the owner. The demand to the lienor must be served on the lienor at the address (and to the attention) of any person designated to receive the demand as stated in the notice to owner. Failure or refusal to provide the statement as directed will not deprive the lienor of his or her lien. (713.16(2)).
A response to the form from the contractor must include a written statement, given under oath, of his or her account showing the nature of the labor or services performed and to be performed, if any, the materials furnished, the materials to be furnished, if known, the amount paid on account to date, the amount due, and the amount to become due, if known, as of the date of the statement for the improvement of the identified real property. (713.16(2)).
The lienor must furnish the requested statement within 30 days of receipt. If the lienor furnishes a false or misleading statement, the lienor will lose the right to recover attorney's fees in any action to enforce the claim of lien. See 713.16(5)(b).
Each case is unique, so contact an attorney with questions about the sworn statement of account, for complex situations, or any other issues relating to Florida's Construction Lien Law.
Our Promise
The documents you receive here will meet, or exceed, the Polk County recording requirements for formatting. If there's an issue caused by our formatting, we'll make it right and refund your payment.
Save Time and Money
Get your Polk County Request for a Sworn Statement of Account form done right the first time with Deeds.com Uniform Conveyancing Blanks. At Deeds.com, we understand that your time and money are valuable resources, and we don't want you to face a penalty fee or rejection imposed by a county recorder for submitting nonstandard documents. We constantly review and update our forms to meet rapidly changing state and county recording requirements for roughly 3,500 counties and local jurisdictions.
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June 29th, 2025
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April 3rd, 2020
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November 30th, 2020
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January 21st, 2021
There is not enough room on the form to describe my property which was taken directly from the previous deed. Other than that worked as expected.
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October 4th, 2020
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February 8th, 2019
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