VA Partial Waiver of Liens 1995

Forms by State
Organization Forms

VA Partial Waiver of Liens 1995

Form Document
V 4

Date: _______________

Original Contract Amount: $_________________

Previous Payments: $_________________

Current Payments: $_________________

Contract Balance: $_________________

STATE OF VIRGINIA _______________________

COUNTY OF FAIRFAX ______________________ ; To wit:

KNOW ALL MEN THAT ___________________________________________, for and in consideration of, the sum of _____________________________________, in payment of invoice or application dated _____________________________, does hereby waive, release and relinquish any and all claims of lien which ______________ now has upon the premises known and described as __________________________, ___________________________________________________________________ for labor, materials and services furnished prior to _____________________________________________________________________ said premises being owned by ____________________________________________ ____________________________________________________________________.


Subscribed and sworn to before me this _____ day of ____________, 20_____.


Notary Public

My Commission Expires: _________________

No guidelines are available for this form at this time.