ST
IN THE 21
JUDICIAL CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
Division:
Case Number:
Lien Claimant:
Claimant’s Address:
City, State, Zip:
Telephone Number:
vs.
Owner/Lessee/Licensee:
Owner/Lessee/Licensee’s Address:
City, State, Zip:
Telephone Number:
(Date File Stamp)
Interested Party:
Interested Party’s Address:
Lien Amount:
City, State, Zip:
Lien Number:
Property Interest:
Telephone Number:
Substitute Collateral:
Certificate of Deposit for Release of Residential Real Property from Mechanic’s Lien
On ____________________ (date), a mechanic’s lien was filed with this court pursuant to Section 429.080, RSMo. On
____________________ (date), the above interested party deposited with this court:
money in the amount of $_______________________
a letter of credit in the amount of $_______________________ from:
name and address of the bank: _____________________________________________________________________
service address for the bank: ______________________________________________________________________
a bond in the amount of $_______________________ from:
name and address of the surety company: ____________________________________________________________
service address for the surety company: _____________________________________________________________
as substitute collateral to release the residential real property from the mechanic’s lien pursuant to Section 429.016, RSMo.
Legal description of the property against which the mechanic’s lien was filed: (
Attach additional pages, if necessary.)
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Certificate of Filing
I, __________________________________________, Clerk of the ___________________________ Court, Division
__________ of ___________________________________ County/City of St. Louis, hereby certify the certificate of deposit was
filed in my office on ____________________________ (date).
W
my hand and the seal of the court affixed hereto on ______________________________________.
ITNESS
_____________________________________________
(Seal of the Court)
Clerk
Certificate of Service
I, the undersigned, certify that I have mailed a copy on _____________________ (date), of the foregoing and a copy of any letter of
credit or bond, if any, to the claimant at the following address:
_________________________________________________________________________________________________________
_______________________________________
Interested Party
OSCA (7-10) GN165
1 of 1
429.016 RSMo
1
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