Fill and Sign the Certificate of Satisfaction of Stop Notice Claim or Notice to Withhold Funds Form

Certificate of Satisfaction of Stop Notice Claim (or Notice to Withhold Funds) On ______________________________ (date) , ________________________________ ______________________________ (Claimant) , referred to herein as Claimant, filed, pursuant to __________________________________ (cite appropriate statute) , a Stop Notice (or Notice to Withhold Funds) for $_______________ for labor performed and materials furnished for improvement of real property, as follows: Date(s) Description Value Total ______________ _________________________________ _______ ______ ______________ _________________________________ _______ ______ ______________ _________________________________ _______ ______ 1. The Notice was filed for record on __________________________________ (date) , and recorded in Book ____ at Page ___ of the lien records in the office of the ___________________ ______________________________________________________________________________ ______________________ (County official’s name and office where such liens are recorded). 2. The property described in the said Stop Notice is at ______________________________ ______________________________________________________________________________ _____________________________________ (street address, city, county, state, zip code) , and is more particularly described as follows: (Legal Description of Property) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3. The O wner of the property is ________________________________________ (Owner) , of ___________________________________________________________________________ ______________________________________________________________________________ _________________________________________ (street address, city, county, state, zip code) . This is to certify that Claimant has received from ________________________________ _________________________________________________ ( Bank) , the fund holder, the sum of $________________ in full payment of the Stop Notice Claim and therefore has settled the said Claim. Claimant is willing, therefore, to have the Stop Notice discharged. Claimant authorizes and directs the _________________________________________________ ______________________________________________________________________________ ___________________________________________ (County official’s name and office where such liens are recorded) to discharge of record the herein described Stop Notice. Witness my signature this the _____ day of _____________________________, 20____. ____________________________________ Claimant Acknowledgement (if required)