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["SWORN STATEMENT\nBGM430 (04/18)",null,null,null,null,null,null,null,null,null,null,null,"Landscape Style - Letter Size - 2 pages"]
[null,null,null,null,null,null,"STATE OF ","MICHIGAN"]
[null,null,null,null,null,null,"COUNTY OF "]
[null,null,"   being duly sworn, deposes and says that he/she/they is/are to be the",null,null,null,"contractor(s)/owner(s)/subcontractor(s)"]
["of an improvement to the following described real property described as follows:",null,null,null,null,null,null,null,null,null,";"]
["AND that the following is a statement of the name of every contractor, subcontractor, material supplier, and laborer with whom the undersigned had contracted; that the amounts due or to become due for work done or to be done, and materials furnished or to be furnished, are correctly and fully set forth opposite their names, as indicated below:"]
[]
["No.","Subtractor","Type of Improvement","Original Contract\n$","Adjust-ments +(-)\n$","Current Contract\n$","Paid\nto Date\n$","Current Request\n$","Balance to Complete\n$","PLW","FLW"]
[1,null,"Permits",null,null,{"$f":"+D9+E9","v":0},null,null,{"$f":"SUM(F9-G9-H9)","v":0}]
[2,null,"Basement Materials/Labor",null,null,{"$f":"+D10+E10","v":0},null,null,0]
[3,null,"Brick, Block",null,null,{"$f":"+D11+E11","v":0},null,null,0]
[4,null,"Mason Labor",null,null,0,null,null,0]
[5,null,"Excavation/Backfilling",null,null,0,null,null,0]
[6,null,"Survey",null,null,0,null,null,0]
[7,null,"Rough Lumber, Flooring",null,null,0,null,null,0]
[8,null,"Rough-In Labor",null,null,0,null,null,0]
[9,null,"Finish Lumber - Hardware",null,null,0,null,null,0]
[10,null,"Finish Labor",null,null,0,null,null,0]
[11,null,"Siding",null,null,0,null,null,0]
[12,null,"Eaves/Downspouts",null,null,0,null,null,0]
[13,null,"Windows/Screens",null,null,0,null,null,0]
[14,null,"Doors - Entrance",null,null,0,null,null,0]
[15,null,"Doors - Interior",null,null,0,null,null,0]
[16,null,"Doors - Garage",null,null,0,null,null,0]
[17,null,"Plumbing - Rough Materials",null,null,0,null,null,0]
[18,null,"Plumbing - Finish Materials",null,null,0,null,null,0]
[19,null,"Plumbing Labor",null,null,0,null,null,0]
[20,null,"Well/Pump/Water Connection",null,null,0,null,null,0]
[21,null,"Septic/Sewer Connection",null,null,0,null,null,0]
[22,null,"Heat/Air Condition Materials",null,null,0,null,null,0]
[23,null,"Heat/Air Condition Labor",null,null,0,null,null,0]
[24,null,"Dry Wall/Plaster",null,null,0,null,null,0]
[25,null,"Dry Wall/Plaster Labor",null,null,0,null,null,0]
[26,null,"Electrical Rough Materials",null,null,0,null,null,0]
[27,null,"Electrical Rough Labor",null,null,0,null,null,0]
[28,null,"Utility Connection Fees",null,null,0,null,null,0]
[29,null,"Electrical Finish Materials",null,null,0,null,null,0]
[30,null,"Electrical Finish Labor",null,null,0,null,null,0]
[31,null,"Painting/Staining Materials",null,null,0,null,null,0]
[32,null,"Painting/Staining Labor",null,null,0,null,null,0]
[33,null,"Insulation Material",null,null,0,null,null,0]
[34,null,"Insulation Labor",null,null,0,null,null,0]
[35,null,"Roofing Material",null,null,0,null,null,0]
[36,null,"Roofing Labor",null,null,0,null,null,0]
[37,null,"Glass/Glazing",null,null,0,null,null,0]
[38,null,"Finish Flooring",null,null,0,null,null,0]
[39,null,"Cabinets - Kitchen",null,null,0,null,null,0]
[40,null,"Cabinets - Other",null,null,0,null,null,0]
[41,null,"Countertops",null,null,0,null,null,0]
[42,null,"Appliances - Kitchen",null,null,0,null,null,0]
[43,null,"Appliances - Other",null,null,0,null,null,0]
[44,null,"Driveway",null,null,0,null,null,0]
[45,null,"Exterior Cement work",null,null,0,null,null,0]
[46,null,"Landscaping",null,null,0,null,null,0]
[47,null,"General Contractor's Fee",null,null,0,null,null,0]
[48,null,"Land ",null,null,0,null,null,0]
[49,null,"Contingency",null,null,0,null,null,0]
[50,null,null,null,null,0,null,null,0]
["TOTALS",null,null,{"$f":"SUM(D9:D58)","v":0},{"$f":"SUM(E9:E58)","v":0},0,0,0,0]
["Deponent further says that he/she/they has/have not employed, procured materials from, or contracted or subcontracted with, any person other than those above mentioned, and owe no money for labor, services or material for the improvement other than the sums set forth above.\n\n"]
["Deponent further says that he/she/they make(s) this Sworn Statement for the purpose of representing to the Lender that the above described real property is free from claims of mechanics' liens and construction liens, except as specifically set forth above.   This Sworn Statement is made with the full knowledge that it will be relied upon by Lender in paying part or all of any sums due for construction of the improvement."]
["Deponent further says that he/she/they make(s) the foregoing statement as the contractor(s)/owner(s)/subcontractor(s)or as the authorized representative of the contractor(s)/owner(s)/ subcontractor(s)for the purpose of representing to the owner or lessee of the above-described premises and his/her/their agent(s) and the mortgagee and that the above-described property is free from claims of construction liens, or the possibility of construction liens, except as specifically set forth above and except for claims of Construction Liens by laborers which may be provided pursuant to section 109 of the Construction Lien Act, Act. No. 497 of the Public Acts of 1980, as amended, being section 570.1109 of Michigan Compiled Laws.  These representations are made with the full knowledge that they will be relied upon by Lender in paying part or all of any sums due any interested party connected herewith."]
["WARNING TO OWNER OR LESSEE:  AN OWNER OR LESSEE OF THE ABOVE-DESCRIBED PROPERTY MAY NOT RELY ON THIS SWORN STATEMENT TO AVOID THE CLAIM OF A SUBCONTRACTOR, SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING OR A LABORER WHO MAY PROVIDE A NOTICE OF FURNISHING PURSUANT TO SECTION 109 OF THE CONSTRUCTION LIEN ACT TO THE DESIGNEE OR TO THE OWNER OR LESSEE IF THE DESIGNEE IS NOT NAMED OR HAS DIED."]
["WARNING TO DEPONENT:  A PERSON, WHO WITH INTENT TO DEFRAUD, GIVES A FALSE SWORN STATEMENT IS SUBJECT TO CRIMINAL PENALTIES AS PROVIDED IN SECTION 110 OF THE CONSTRUCTION LIEN ACT, ACT NO. 497 OF THE PUBLIC ACTS OF 1980, AS AMENDED, BEING SECTION 570.1110 OF THE MICHIGAN COMPILED LAWS."]
["ON RECEIPT OF THIS SWORN STATEMENT, THE OWNER OR LESSEE, OR THE OWNER'S OR LESSEE'S DESIGNEE, MUST GIVE NOTICE OF ITS RECEIPT, EITHER IN WRITING, OR TELEPHONE, OR PERSONALLY, TO EACH SUBCONTRACTOR, SUPPLIER, AND LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING UNDER SECTION 109 OR, IF A NOTICE OF FURNISHING IS EXCUSED UNDER SECTION 108 OR 108A, TO EACH SUBCONTRACTOR, SUPPLIER, AND LABORER NAMED IN THE SWORN STATEMENT.  IF A SUBCONTRACTOR, SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING OR WHO IS NAMED IN THE SWORN STATEMENT MAKES A REQUEST, THE OWNER, LESSEE, OR DESIGNEE SHALL PROVIDE THE REQUESTER A COPY OF THE SWORN STATEMENT WITHIN 10 BUSINESS DAYS AFTER RECEIVING THE REQUEST."]
["An electronic reproduction of this fully-executed document shall be as valid as the original."]
["CONTRACTOR(S), OWNER(S), SUBCONTRACTOR(S):"]
[]
[]
[]
[null,null,"Subscribed and sworn to before me this ",null,null,"day of ",null,null,", "]
[]
[]
[null,null,null,"Notary Public:"]
[null,null,null,"Commission Expires:"]
[null,null,null,null,null,null,"County, Michigan"]

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["SWORN STATEMENT\nBGM430 (04/18)",null,null,null,null,null,null,null,null,null,null,null,"Portrait Style - Legal Size - 1 page"]
[null,null,null,null,null,null,"STATE OF ","MICHIGAN"]
[null,null,null,null,null,null,"COUNTY OF "]
[null,null,"   being duly sworn, deposes and says that he/she/they is/are to be the",null,null,null,"contractor(s)/owner(s)/subcontractor(s)",null,null,"of an"]
["improvement to the following described real property described as follows:",null,null,null,null,null,null,null,null,null,";"]
["AND that the following is a statement of the name of every contractor, subcontractor, material supplier, and laborer with whom the undersigned had contracted; that the amounts due or to become due for work done or to be done, and materials furnished or to be furnished, are correctly and fully set forth opposite their names, as indicated below:"]
[]
["No.","Subtractor","Type of Improvement","Original Contract\n$","Adjust-ments +(-)\n$","Current Contract\n$","Paid\nto Date\n$","Current Request\n$","Balance to Complete\n$","PLW","FLW"]
[1,null,"Permits",null,null,{"$f":"+D9+E9","v":0},null,null,{"$f":"SUM(F9-G9-H9)","v":0}]
[2,null,"Basement Materials/Labor",null,null,{"$f":"+D10+E10","v":0},null,null,0]
[3,null,"Brick, Block",null,null,{"$f":"+D11+E11","v":0},null,null,0]
[4,null,"Mason Labor",null,null,0,null,null,0]
[5,null,"Excavation/Backfilling",null,null,0,null,null,0]
[6,null,"Survey",null,null,0,null,null,0]
[7,null,"Rough Lumber, Flooring",null,null,0,null,null,0]
[8,null,"Rough-In Labor",null,null,0,null,null,0]
[9,null,"Finish Lumber - Hardware",null,null,0,null,null,0]
[10,null,"Finish Labor",null,null,0,null,null,0]
[11,null,"Siding",null,null,0,null,null,0]
[12,null,"Eaves/Downspouts",null,null,0,null,null,0]
[13,null,"Windows/Screens",null,null,0,null,null,0]
[14,null,"Doors - Entrance",null,null,0,null,null,0]
[15,null,"Doors - Interior",null,null,0,null,null,0]
[16,null,"Doors - Garage",null,null,0,null,null,0]
[17,null,"Plumbing - Rough Materials",null,null,0,null,null,0]
[18,null,"Plumbing - Finish Materials",null,null,0,null,null,0]
[19,null,"Plumbing Labor",null,null,0,null,null,0]
[20,null,"Well/Pump/Water Connection",null,null,0,null,null,0]
[21,null,"Septic/Sewer Connection",null,null,0,null,null,0]
[22,null,"Heat/Air Condition Materials",null,null,0,null,null,0]
[23,null,"Heat/Air Condition Labor",null,null,0,null,null,0]
[24,null,"Dry Wall/Plaster",null,null,0,null,null,0]
[25,null,"Dry Wall/Plaster Labor",null,null,0,null,null,0]
[26,null,"Electrical Rough Materials",null,null,0,null,null,0]
[27,null,"Electrical Rough Labor",null,null,0,null,null,0]
[28,null,"Utility Connection Fees",null,null,0,null,null,0]
[29,null,"Electrical Finish Materials",null,null,0,null,null,0]
[30,null,"Electrical Finish Labor",null,null,0,null,null,0]
[31,null,"Painting/Staining Materials",null,null,0,null,null,0]
[32,null,"Painting/Staining Labor",null,null,0,null,null,0]
[33,null,"Insulation Material",null,null,0,null,null,0]
[34,null,"Insulation Labor",null,null,0,null,null,0]
[35,null,"Roofing Material",null,null,0,null,null,0]
[36,null,"Roofing Labor",null,null,0,null,null,0]
[37,null,"Glass/Glazing",null,null,0,null,null,0]
[38,null,"Finish Flooring",null,null,0,null,null,0]
[39,null,"Cabinets - Kitchen",null,null,0,null,null,0]
[40,null,"Cabinets - Other",null,null,0,null,null,0]
[41,null,"Countertops",null,null,0,null,null,0]
[42,null,"Appliances - Kitchen",null,null,0,null,null,0]
[43,null,"Appliances - Other",null,null,0,null,null,0]
[44,null,"Driveway",null,null,0,null,null,0]
[45,null,"Exterior Cement work",null,null,0,null,null,0]
[46,null,"Landscaping",null,null,0,null,null,0]
[47,null,"General Contractor's Fee",null,null,0,null,null,0]
[48,null,"Land ",null,null,0,null,null,0]
[49,null,"Contingency",null,null,0,null,null,0]
[50,null,null,null,null,0,null,null,0]
["TOTALS",null,null,{"$f":"SUM(D9:D58)","v":0},{"$f":"SUM(E9:E58)","v":0},0,0,0,0]
["Deponent further says that he/she/they has/have not employed, procured materials from, or contracted or subcontracted with, any person other than those above mentioned, and owe no money for labor, services or material for the improvement other than the sums set forth above.\n\n"]
["Deponent further says that he/she/they make(s) this Sworn Statement for the purpose of representing to the Lender that the above described real property is free from claims of mechanics' liens and construction liens, except as specifically set forth above.   This Sworn Statement is made with the full knowledge that it will be relied upon by Lender in paying part or all of any sums due for construction of the improvement."]
["Deponent further says that he/she/they make(s) the foregoing statement as the contractor(s)/owner(s)/subcontractor(s)or as the authorized representative of the contractor(s)/owner(s)/ subcontractor(s)for the purpose of representing to the owner or lessee of the above-described premises and his/her/their agent(s) and the mortgagee and that the above-described property is free from claims of construction liens, or the possibility of construction liens, except as specifically set forth above and except for claims of Construction Liens by laborers which may be provided pursuant to section 109 of the Construction Lien Act, Act. No. 497 of the Public Acts of 1980, as amended, being section 570.1109 of Michigan Compiled Laws.  These representations are made with the full knowledge that they will be relied upon by Lender in paying part or all of any sums due any interested party connected herewith."]
["WARNING TO OWNER OR LESSEE:  AN OWNER OR LESSEE OF THE ABOVE-DESCRIBED PROPERTY MAY NOT RELY ON THIS SWORN STATEMENT TO AVOID THE CLAIM OF A SUBCONTRACTOR, SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING OR A LABORER WHO MAY PROVIDE A NOTICE OF FURNISHING PURSUANT TO SECTION 109 OF THE CONSTRUCTION LIEN ACT TO THE DESIGNEE OR TO THE OWNER OR LESSEE IF THE DESIGNEE IS NOT NAMED OR HAS DIED."]
["WARNING TO DEPONENT:  A PERSON, WHO WITH INTENT TO DEFRAUD, GIVES A FALSE SWORN STATEMENT IS SUBJECT TO CRIMINAL PENALTIES AS PROVIDED IN SECTION 110 OF THE CONSTRUCTION LIEN ACT, ACT NO. 497 OF THE PUBLIC ACTS OF 1980, AS AMENDED, BEING SECTION 570.1110 OF THE MICHIGAN COMPILED LAWS."]
["ON RECEIPT OF THIS SWORN STATEMENT, THE OWNER OR LESSEE, OR THE OWNER'S OR LESSEE'S DESIGNEE, MUST GIVE NOTICE OF ITS RECEIPT, EITHER IN WRITING, OR TELEPHONE, OR PERSONALLY, TO EACH SUBCONTRACTOR, SUPPLIER, AND LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING UNDER SECTION 109 OR, IF A NOTICE OF FURNISHING IS EXCUSED UNDER SECTION 108 OR 108A, TO EACH SUBCONTRACTOR, SUPPLIER, AND LABORER NAMED IN THE SWORN STATEMENT.  IF A SUBCONTRACTOR, SUPPLIER, OR LABORER WHO HAS PROVIDED A NOTICE OF FURNISHING OR WHO IS NAMED IN THE SWORN STATEMENT MAKES A REQUEST, THE OWNER, LESSEE, OR DESIGNEE SHALL PROVIDE THE REQUESTER A COPY OF THE SWORN STATEMENT WITHIN 10 BUSINESS DAYS AFTER RECEIVING THE REQUEST."]
["An electronic reproduction of this fully-executed document shall be as valid as the original."]
["CONTRACTOR(S), OWNER(S), SUBCONTRACTOR(S):"]
[]
[]
[]
[]
[null,null,"Subscribed and sworn to before me this ",null,null,"day of ",null,null,", "]
[]
[]
[null,null,null,"Notary Public:"]
[null,null,null,"Commission Expires:"]
[null,null,null,null,null,null,"County, Michigan"]

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["SWORN STATEMENT\nBGM430 (04/18)",null,null,null,null,null,null,null,null,null,null,null,"Landscape Style - Letter Size - 2 pages"]
[null,null,null,null,null,null,"STATE OF ","WISCONSIN"]
[null,null,null,null,null,null,"COUNTY OF "]
[null,null,"being duly sworn, deposes and says that he/she/they is/are to be the",null,null,null,"contractor(s)/owner(s)/subcontractor(s)"]
["of an improvement to the following described real property described as follows:",null,null,null,null,null,null,null,null,null,";"]
["AND that the following is a statement of the name of every contractor, subcontractor, material supplier, and laborer with whom the undersigned had contracted; that the amounts due or to become due for work done or to be done, and materials furnished or to be furnished, are correctly and fully set forth opposite their names, as indicated below:"]
[]
["No.","Subtractor/Supplier/Laborer","Type of Improvement","Original Contract\n$","Adjust-ments +(-)\n$","Current Contract\n$","Paid\nto Date\n$","Current Request\n$","Balance to Complete\n$","PLW","FLW"]
[1,null,"Permits",null,null,{"$f":"+D9+E9","v":0},null,null,{"$f":"SUM(F9-G9-H9)","v":0}]
[2,null,"Basement Materials/Labor",null,null,{"$f":"+D10+E10","v":0},null,null,0]
[3,null,"Brick, Block",null,null,{"$f":"+D11+E11","v":0},null,null,0]
[4,null,"Mason Labor",null,null,0,null,null,0]
[5,null,"Excavation/Backfilling",null,null,0,null,null,0]
[6,null,"Survey",null,null,0,null,null,0]
[7,null,"Rough Lumber, Flooring",null,null,0,null,null,0]
[8,null,"Rough-In Labor",null,null,0,null,null,0]
[9,null,"Finish Lumber - Hardware",null,null,0,null,null,0]
[10,null,"Finish Labor",null,null,0,null,null,0]
[11,null,"Siding",null,null,0,null,null,0]
[12,null,"Eaves/Downspouts",null,null,0,null,null,0]
[13,null,"Windows/Screens",null,null,0,null,null,0]
[14,null,"Doors - Entrance",null,null,0,null,null,0]
[15,null,"Doors - Interior",null,null,0,null,null,0]
[16,null,"Doors - Garage",null,null,0,null,null,0]
[17,null,"Plumbing - Rough Materials",null,null,0,null,null,0]
[18,null,"Plumbing - Finish Materials",null,null,0,null,null,0]
[19,null,"Plumbing Labor",null,null,0,null,null,0]
[20,null,"Well/Pump/Water Connection",null,null,0,null,null,0]
[21,null,"Septic/Sewer Connection",null,null,0,null,null,0]
[22,null,"Heat/Air Condition Materials",null,null,0,null,null,0]
[23,null,"Heat/Air Condition Labor",null,null,0,null,null,0]
[24,null,"Dry Wall/Plaster",null,null,0,null,null,0]
[25,null,"Dry Wall/Plaster Labor",null,null,0,null,null,0]
[26,null,"Electrical Rough Materials",null,null,0,null,null,0]
[27,null,"Electrical Rough Labor",null,null,0,null,null,0]
[28,null,"Utility Connection Fees",null,null,0,null,null,0]
[29,null,"Electrical Finish Materials",null,null,0,null,null,0]
[30,null,"Electrical Finish Labor",null,null,0,null,null,0]
[31,null,"Painting/Staining Materials",null,null,0,null,null,0]
[32,null,"Painting/Staining Labor",null,null,0,null,null,0]
[33,null,"Insulation Material",null,null,0,null,null,0]
[34,null,"Insulation Labor",null,null,0,null,null,0]
[35,null,"Roofing Material",null,null,0,null,null,0]
[36,null,"Roofing Labor",null,null,0,null,null,0]
[37,null,"Glass/Glazing",null,null,0,null,null,0]
[38,null,"Finish Flooring",null,null,0,null,null,0]
[39,null,"Cabinets - Kitchen",null,null,0,null,null,0]
[40,null,"Cabinets - Other",null,null,0,null,null,0]
[41,null,"Countertops",null,null,0,null,null,0]
[42,null,"Appliances - Kitchen",null,null,0,null,null,0]
[43,null,"Appliances - Other",null,null,0,null,null,0]
[44,null,"Driveway",null,null,0,null,null,0]
[45,null,"Exterior Cement work",null,null,0,null,null,0]
[46,null,"Landscaping",null,null,0,null,null,0]
[47,null,"General Contractor's Fee",null,null,0,null,null,0]
[48,null,"Land ",null,null,0,null,null,0]
[49,null,"Contingency",null,null,0,null,null,0]
[50,null,null,null,null,0,null,null,0]
["TOTALS",null,null,{"$f":"SUM(D9:D58)","v":0},{"$f":"SUM(E9:E58)","v":0},0,0,0,0]
["Deponent further says that he/she/they has/have not employed, procured materials from, or contracted or subcontracted with, any person other than those above mentioned, and owe no money for labor, services or material for the improvement other than the sums set forth above."]
["Deponent further says that he/she/they make(s) this Sworn Statement for the purpose of representing to the Lender that the above described real property is free from claims of mechanics' liens and construction liens, except as specifically set forth above.   This Sworn Statement is made with the full knowledge that it will be relied upon by Lender in paying part or all of any sums due for construction of the improvement."]
["An electronic reproduction of this fully-executed document shall be as valid as the original."]
["CONTRACTOR(S), OWNER(S), SUBCONTRACTOR(S):"]
[]
[]
[]
[]
[null,null,"Subscribed and sworn to before me this ",null,null,"day of ",null,null,", "]
[]
[]
[null,null,null,"Notary Public:"]
[null,null,null,"Commission Expires:"]
[null,null,null,null,null,null,"County, Wisconsin"]

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["SWORN STATEMENT\nBGM430 (04/18)",null,null,null,null,null,null,null,null,null,null,null,"Portrait Style - Legal Size - 1 page"]
[null,null,null,null,null,null,"STATE OF ","WISCONSIN"]
[null,null,null,null,null,null,"COUNTY OF "]
[null,null,"being duly sworn, deposes and says that he/she/they is/are to be the",null,null,null,"contractor(s)/owner(s)/subcontractor(s)",null,null,"of an"]
["improvement to the following described real property described as follows:",null,null,null,null,null,null,null,null,null,";"]
["AND that the following is a statement of the name of every contractor, subcontractor, material supplier, and laborer with whom the undersigned had contracted; that the amounts due or to become due for work done or to be done, and materials furnished or to be furnished, are correctly and fully set forth opposite their names, as indicated below:"]
[]
["No.","Subtractor / Supplier / Laborer","Type of Improvement","Original Contract\n$","Adjust-ments +(-)\n$","Current Contract\n$","Paid\nto Date\n$","Current Request\n$","Balance to Complete\n$","PLW","FLW"]
[1,null,"Permits",null,null,{"$f":"+D9+E9","v":0},null,null,{"$f":"SUM(F9-G9-H9)","v":0}]
[2,null,"Basement Materials/Labor",null,null,{"$f":"+D10+E10","v":0},null,null,0]
[3,null,"Brick, Block",null,null,{"$f":"+D11+E11","v":0},null,null,0]
[4,null,"Mason Labor",null,null,0,null,null,0]
[5,null,"Excavation/Backfilling",null,null,0,null,null,0]
[6,null,"Survey",null,null,0,null,null,0]
[7,null,"Rough Lumber, Flooring",null,null,0,null,null,0]
[8,null,"Rough-In Labor",null,null,0,null,null,0]
[9,null,"Finish Lumber - Hardware",null,null,0,null,null,0]
[10,null,"Finish Labor",null,null,0,null,null,0]
[11,null,"Siding",null,null,0,null,null,0]
[12,null,"Eaves/Downspouts",null,null,0,null,null,0]
[13,null,"Windows/Screens",null,null,0,null,null,0]
[14,null,"Doors - Entrance",null,null,0,null,null,0]
[15,null,"Doors - Interior",null,null,0,null,null,0]
[16,null,"Doors - Garage",null,null,0,null,null,0]
[17,null,"Plumbing - Rough Materials",null,null,0,null,null,0]
[18,null,"Plumbing - Finish Materials",null,null,0,null,null,0]
[19,null,"Plumbing Labor",null,null,0,null,null,0]
[20,null,"Well/Pump/Water Connection",null,null,0,null,null,0]
[21,null,"Septic/Sewer Connection",null,null,0,null,null,0]
[22,null,"Heat/Air Condition Materials",null,null,0,null,null,0]
[23,null,"Heat/Air Condition Labor",null,null,0,null,null,0]
[24,null,"Dry Wall/Plaster",null,null,0,null,null,0]
[25,null,"Dry Wall/Plaster Labor",null,null,0,null,null,0]
[26,null,"Electrical Rough Materials",null,null,0,null,null,0]
[27,null,"Electrical Rough Labor",null,null,0,null,null,0]
[28,null,"Utility Connection Fees",null,null,0,null,null,0]
[29,null,"Electrical Finish Materials",null,null,0,null,null,0]
[30,null,"Electrical Finish Labor",null,null,0,null,null,0]
[31,null,"Painting/Staining Materials",null,null,0,null,null,0]
[32,null,"Painting/Staining Labor",null,null,0,null,null,0]
[33,null,"Insulation Material",null,null,0,null,null,0]
[34,null,"Insulation Labor",null,null,0,null,null,0]
[35,null,"Roofing Material",null,null,0,null,null,0]
[36,null,"Roofing Labor",null,null,0,null,null,0]
[37,null,"Glass/Glazing",null,null,0,null,null,0]
[38,null,"Finish Flooring",null,null,0,null,null,0]
[39,null,"Cabinets - Kitchen",null,null,0,null,null,0]
[40,null,"Cabinets - Other",null,null,0,null,null,0]
[41,null,"Countertops",null,null,0,null,null,0]
[42,null,"Appliances - Kitchen",null,null,0,null,null,0]
[43,null,"Appliances - Other",null,null,0,null,null,0]
[44,null,"Driveway",null,null,0,null,null,0]
[45,null,"Exterior Cement work",null,null,0,null,null,0]
[46,null,"Landscaping",null,null,0,null,null,0]
[47,null,"General Contractor's Fee",null,null,0,null,null,0]
[48,null,"Land ",null,null,0,null,null,0]
[49,null,"Contingency",null,null,0,null,null,0]
[50,null,null,null,null,0,null,null,0]
["TOTALS",null,null,{"$f":"SUM(D9:D58)","v":0},{"$f":"SUM(E9:E58)","v":0},0,0,0,0]
["Deponent further says that he/she/they has/have not employed, procured materials from, or contracted or subcontracted with, any person other than those above mentioned, and owe no money for labor, services or material for the improvement other than the sums set forth above."]
["Deponent further says that he/she/they make(s) this Sworn Statement for the purpose of representing to the Lender that the above described real property is free from claims of mechanics' liens and construction liens, except as specifically set forth above.   This Sworn Statement is made with the full knowledge that it will be relied upon by Lender in paying part or all of any sums due for construction of the improvement."]
["An electronic reproduction of this fully-executed document shall be as valid as the original."]
["CONTRACTOR(S), OWNER(S), SUBCONTRACTOR(S):"]
[]
[]
[]
[]
[null,null,"Subscribed and sworn to before me this ",null,null,"day of ",null,null,", "]
[]
[]
[null,null,null,"Notary Public:"]
[null,null,null,"Commission Expires:"]
[null,null,null,null,null,null,"County, Wisconsin"]