Release And Discharge Of Mechanic'S Lien Form Page 2
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1
2ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of New York, County of
, ss:
State of New York, County of
, ss:
On the
day of
in the year
,
On the
day of
in the year
,
before me, the undersigned, personally appeared
before me, the undersigned, personally appeared
personally known to me or proved to me on the basis of satisfactory
personally known to me or proved to me on the basis of satisfactory
evidence to be the individual(s) whose name(s) is (are) subscribed to
evidence to be the individual(s) whose name(s) is (are) subscribed to
the within instrument and acknowledged to me that he/she/they
the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their capacity(ies), and that by
executed the same in his/her/their capacity(ies), and that by
his/her/their signature(s) on the instrument, the individual(s), or the
his/her/their signature(s) on the instrument, the individual(s), or the
person upon behalf of which the individual(s) acted, executed the
person upon behalf of which the individual(s) acted, executed the
instrument.
instrument.
ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK
ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS
STATE
TAKEN IN NEW YORK STATE
♦State of
, County of
, ss:
State of New York, County of
, ss:
*(Or insert District of Columbia, Territory, Possession or Foreign County)
On the
day of
in the year
,
On the
day of
in the year
,
before me, the undersigned, a Notary Public in and for said State,
before me, the undersigned, personally appeared
personally appeared
personally known to me or proved to me on the basis of satisfactory
the subscribing witness to the foregoing instrument, with whom I am
evidence to be the individual(s) whose name(s) is (are) subscribed to
personally acquainted, who, being by me duly sworn, did depose and
the within instrument and acknowledged to me that he/she/they
say that he/she/they reside(s) in
executed the same in his/her/their capacity(ies), that by his/her/their
signature(s) on the instrument, the individual(s) or the person upon
behalf of which the individual(s) acted, executed the instrument, and
that such individual make such appearance before the undersigned in
(if the place of residence is in a city, include the street and street number if any, thereof);
that he/she/they know(s)
the
(add the city or political subdivision and the state or country or other
to be the individual described in and who executed the foregoing
place the acknowledgement was taken).
instrument; that said subscribing witness was present and saw said
execute the same; and that said witness at the same time subscribed
his/her/their name(s) as a witness thereto
SECTION:
Title No.
BLOCK:
LOT:
TO
COUNTY OR TOWN:
RETURN BY MAIL TO:
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