WHEN RECORDED RETURN TO:
City, State, Zip ____________________
Stewart Title Guaranty Company
PARTIAL WAIVER OF LIEN
To ___________________________________________________________, owner of the premises located at and known as _____________________________ _____________________________________ and TO ALL WHOM IT MAY CONCERN:
IN CONSIDERATION of the sum of ______________________________
____________________ Dollars ($_________________ ) and other good and valuable considerations this day in hand paid, receipt whereof is hereby acknowledged, the undersigned, as __________ contractor for the __________________________________
________________________________ work (labor and materials) for the building ____ now in the course of construction upon the above mentioned premises, and/or for otherwise improving said premises, hereby waives and releases all claims, liens, and right to lien, for any and all work, labor, and material by _______ performed and furnished in, upon and about said premises under the terms of ___________________ said _________ contract, to and including the _____________ day of _________________, _______ ; and the undersigned hereby acknowledges that all and singular payments heretofore received, and settlements made by __________________ on account of said _________ contract, have been and are hereby accepted by the undersigned in full satisfaction of the claims, liens, and right to lien, so far waived and released, irrespective of the form or forms of such payments and settlements.
WITNESS ______ hand ______ this _______ day of _______________________
_________, at _________________________________________.
No guidelines are available for this form at this time.