Release Of Stop Payment Notice Form - California

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(Civil Code § 8128)
(owner, construction lender or public entity)
YOU ARE HEREBY NOTIFIED that the undersigned claimant releases that certain Stop Payment
Notice dated ______________, in the amount of $________________ against _______________________
______________________________________________________________________________ as owner or
public body and _______________________________________________ as direct contractor in connection
with the work or improvement known as ____________________________________________ in the City of
_______________, County of _______________, State of California. This Release of Stop Payment Notice is
given pursuant to Civil Code section 8128 and shall be effective only to release the Stop Payment Notice
identified in this document and shall not release any other claim or rights to enforce payment of the Claimant.
Name of Claimant: _________________________________
Address: _________________________________
Telephone: _________________________________
By: _________________________________
I, the undersigned, state: I am the ________________ of the claimant named in the foregoing Release; I have
read said Release of Stop Payment Notice and know the contents thereof, and I certify that the same is true of
my knowledge. I certify (or declare) under penalty of perjury under the laws of the State of California that the
foregoing is true and correct.
Executed on ____________________, 20___, at _____________________, State of California.
Signature of Claimant or Authorized Agent
C&B Forms 03/2012


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