Fill and Sign the Between the Owner Name Address and Other Information

Mutual Release of Notice of Contract with Affidavit Page 1 of 2 MUTUAL RELEASE OF NOTICE OF CONTRACT WITH AFFIDAVIT - INDIVIDUAL (La.Rev.Stats § 9:4811(E) ) COMES NOW, __________________________________ , a s Contractor whose address is ________________________________________________________________ , and __________________________________ as Owner whose address is ________________________________________________________________ , and files this Mutual Release of No tice of Contract with Affidavit , and would provide the following: (1) The parties entered into an employment/contract for work to be performed on the land located at and described as ________________________________________________________________________ on : ________________________________________________________________________ (date). (2) No work ha d begun on the land as of ________________________________________________________________________ (date). (3) Contractor and Owner desire to hereby mutually release the Notice of Contract filed on ________________________________________________________________________ (date) for the project at the above -described property, making the Notice of Contract ineffective . (4) The recorder of mortgages shall immediately cancel the contract upon the filing of this Mutual Release with Affidavit . (5) If the contract, or a certified copy, is refiled, the refiling date shall become the effective date for privilege for work done pursuan t to the contract in accordance with La. Rev. Stats . § 9:4820 (A)(1). Dated: __________________ ______________________________ ________________________________ Signature of Contractor Signature of Owner _____ _________________________ _____ ___________________________ Type or Print Name Type or Print Name Mutual Release of Notice of Contract with Affidavit Page 2 of 2 Affidavit of Engineer, Surveyor, Architect or Building Inspector COMES NOW, ____________ ______________________ , as an ________________________________ (engineer or surveyor, licensed architect, or building inspector employed by the city or parish or by a lending institution chartered under federal or state law ), and would provide the following: (1) The undersigned inspected the immovable located at ________________________________________________________________________ on ________________________________________________________________________ at __________________________________________________________ ______________ (da te and time subsequent to the filing of the contract ). (2) No work has begun on the land and no materials have been placed at the site located at and described as: ________________________________________________________________________ . Dated: __________________ ___________________________ _____ Signature _____ ___________________________ Type or Print Name STATE OF LOUISIANA COUNTY OF ___________________ On this _______ day of ________, 20__, __________ before me personally appear ed _______________________________ , to me known to be the person (or persons) described in and who executed the foregoing instrument, and acknowledged that he or she (or they) executed it as his or her (or their) free act and deed. ______________________ ________ Notary Public ______________________________ Type or Print Name ______________________________ Title (and Rank) (Seal, if any) My appointment expires: ___________________