Fill and Sign the Content Neutrality for Wiki Systems from Neutral Point of Form

Unconditional Waiver and Release of Lien Page 1 of 2 Prepared by, recording requested by and return to: Name: ___________________ Company: ___________________ Address: ____________________ City: ___________________ State: _____ Zip: __________ Phone: _________________ Fax: __________________ ----------------------Above this Line for Official Use Only--------------------- UNCONDITIONAL WAIVER AND RELEASE OF LIEN UPON FINAL PAYMENT On this _____ day of ________________, 20______, the undersigned lienor, whose address is ______________________________________________________________________, in consideration of the final payment in the amount of $__________________, hereby waives and releases his or her 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 property located at and described as: _______________________________________________________________________________________________________________________________________________________________________________________________________________________. ______________________________ Signature of Lien Holder______________________________ Type or Print Name Unconditional Waiver and Release of Lien Page 2 of 2 STATE OF NORTH DAKOTA COUNTY OF ________________ The foregoing instrument was acknowledged before me this _____ day of ________________, 20______ by ________________________________ (name of person acknowledging). _____________________________ Notary Public Printed Name: _________________ My Commission Expires: ________________