WAI VER OF LI EN

On [ dat e] , [ name of cl ai mant ] , of [ addr ess]

, Ci t y of [ ci t y] , Count y of [ count y] ,

St at e of [ st at e] , ent er ed i nt o a cont r act wi t h [ name

of owner ] , t o f ur ni sh [ descr i pt i on of l abor and

mat er i al s] f or t he [ const r uct i on or wor k per f or med]

on pr oper t y owned by [ name of owner ] , of [ pr oper t y

addr ess wher e wor k was per f or med] , t he descr i pt i on of whi ch

i s as f ol l ows:



I n consi der at i on of [ amount ] Dol l ar s,

( $ ) , r ecei pt of whi ch i s her eby acknowl edged,

[ cl ai mant ] her eby wai ves any r i ght t o cl ai ma mechani c' s

l i en agai nst t he above descr i bed pr oper t y, or any

i mpr ovement s t her eon, i n or der t o secur e payment f or t he

ser vi ces he has f ur ni shed under t he her ei n ment i oned

cont r act .



Thi s wai ver has been execut ed by [ cl ai mant ] vol unt ar i l y

and wi t h f ul l knowl edge of t he r i ght s af f or ded hi munder

t he l aws of t he St at e of [ st at e]



Dat ed: ________________________

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