Fill and Sign the Conditional Waiver and Release of Lien Upon Progress Payment Iowa Form

Conditional Waiver and Release of Lien Upon Progress Payment On this _____ day of ________________ , 20 ______ , the undersigned lienor, in consideration of the sum of $ ___________________ , does hereby waive and release the lienor’s lien and right to claim a lien for labor, services or materials furnished through __________________ , 20 _____ , to __________________________ (customer) on the job of ____________________________________ (owner of property) to the following described property: ________________________________________________________________________ ________________________________________________________________________ ___________________________________________________________________ . This Conditional Waiver and Release of Lien Upon Progress Payment is conditioned upon the undersigned receiving collected funds in the amount of $ ___________________ for the work described herein. Should these funds not be received within _____ days of the date hereof, this Conditional Waiver and Release of Lien is void. This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified. __________________________________ Signature of Lien Holder _____ _____________________________ Type or Print Name STATE OF IOWA COUNTY OF ______________________ On this ____________ day of ______________________, ___________, before me, a Notary Public, personally appeared __________________________________, to me known to be the person named in and who executed the foregoing instrument, and acknowledged that he/she/they executed the same as his/her/their voluntary act and deed. ______________________________ Notary Public Print Name: ___________________ (Seal, if any) My commission expires: ____________________ Conditional Waiver and Release of Lien Page 1 of 1