Waiver Of Lien Partial Conditional - Corporate Settlement Solutions

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Waiver of Lien -- Partial Conditional
PARTIAL CONDITIONAL WAIVER
[I / We] have a contract with ________________________________________ [other contracting
party] to provide ______________________________________________ for the improvement
to
the property described as __________________________________________, and hereby waive
[my / our] construction lien to the amount of $_______________, for [labor / materials]
provided
through __________________[date].
This waiver, together with all previous waivers, if any, [does / does not] cover all amounts due
to
[me / us] for contract improvement provided through the date shown above.
This waiver is conditioned on actual payment of the amount shown above.
If the owner or lessee of the property or the owner’s or lessee’s designee has received a notice of
furnishing from me/one of us or if I/we are not required to provide one, and the owner, lessee, or
designee has not received this waiver directly from me/one of us, the owner, lessee, or designee
may not rely upon it without contacting me/one of us, either in writing by telephone, or
personally, to verify that it is authentic.
______________________________
(company)
______________________________
(signature of lien claimant)
Signed on: __________________[date]
Address: _____________________
______________________________
Telephone: ___________________
DO NOT SIGN BLANK OR INCOMPLETE FORMS. RETAIN A COPY.
File No. ____________________

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