Conditional Waiver Of Mechanic'S Lien Form printable pdf download

Conditional Waiver Of Mechanic'S Lien Form

CONDITIONAL WAIVER OF MECHANIC’S LIEN

TO ALL WHOM IT MAY CONCERN:

The undersigned, in consideration of the sum of $ __________________, if any, which is due, or

to become due to he/she or any of them, for labor or work performed and/or material furnished to the

construction project commonly known as ___________________________________________ located

at _______________________

And owned by __________________________________________

The individual signing this lien waiver on behalf of the undersigned hereby warrants that he/she

has full authority to execute this lien waiver.

_____________ __, 2011

_________________________________

By: ______________________________

Its: ______________________________

STATE OF OHIO

}

} SS:

COUNTY OF _________}

Be it Remembered that on this _____ day of ________________, 2011 before me, the

subscriber, a Notary Public in and for said County and State, personally appeared by, _______________,

its ___________, who acknowledged that he/she did execute the foregoing instrument and that such

execution is his/her and its free and voluntary act and deed for the uses and purposes described herein.

IN TESTIMONY THEREOF, I have hereunto signed my name and affixed my official seal on the day

and year aforesaid.

______________________________________

Notary Public

Conditional Waiver Of Mechanic'S Lien Form