Waiver and Release of Lien Upon Final Payment

The undersigned lienor, in consideration of the final payment in the amount of $_________________ hereby waives and releases its lien and right to claim a lien for labor, services, or materials furnished to ____________________________.

(Insert name of customer)

on the job  _____________________________________________________.

(insert name of owner)

to the following prescribed property:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.

(insert description of property)

DATED on __________ , ____

________________________

BY:______________________

(lienor)

Received by:

_____________________________