Fill and Sign the Affidavit Cancellation Form

In the District Court of _____________________ County State of Oklahoma ____________________________ } } vs. } Case No. _____________________ } ____________________________ } Affidavit of Cancellation of Lien- Individual State of Oklahoma } } SS County of ___________________ } __________________________________ , of lawful age, first being duly sworn, deposes and says: 1. That your affiant is the owner of land situated in ___________________________________ County more particularly described as follows: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________ 2. That on the _____ day of ___________________ , 20 ______ , a lien was filed by _________________________________ against __________________________________ on the above-described property. 3. That the lien numbered __________________ was filed with the County Clerk of ____________________ County and is located in Book ________ , Page ______ . 4. That no action to foreclose or adjudicate the lien has been instituted within one (1) year of filing the lien. 5. That the lien is cancelled by limitation of law pursuant to 42 O.S. 1995 Supp. §177. 6. That this affidavit shall be filed in the Office of the County Clerk of ________________ County and shall be attached to the original lien document and in the lien file and a notation of this affidavit shall be entered in the mechanics’ lien journal. Further, your affiant sayeth not. Affidavit of Cancellation of Lien Page 1 of 2 ___________________________________ Affiant and Land Owner _____ _______________________________ Type or Print Name Signed and sworn to before me this ________ day of _____________________, 20_____. ___________________________________ Notary Public Originally Adopted 2/12/96 My commission expires: ________________________________ Revised 7/05 AOC Form 04 Affidavit of Cancellation of Lien Page 2 of 2