Fill and Sign the Ct Corporation Llc Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: _____________________ Company: ____________________ Address: ______________________ City: __________________________ State: _____ Zip: _________ Phone: _____________________ Fax: _______________________ DISCHARGE AND RELEASE OF LIEN – CORPORATION or LLC (Conn. Gen. Stat. § 49-51) COMES NOW, ___________________________________ , as a representative of ___________________________________ a ____________________ business entity having filed a certificate of lien claiming a lien interest in the real property described as: ________________________________________________________________________ _____________________________________________________________________ , and would state as follows: 1. On or about the _____ day of _________________ , 20 _____ , the undersigned; ( ) received a request from __________________________________ , requesting a release of the above-mentioned lien. ( ) received satisfaction of the lien claim in full. 2. The undersigned filed a certificate of lien on or about the _____ day of ________________ , 20 _____ , said lien being recorded in the records of ___________________ , Town _________________________ , Volume _________ , Page _______ . 3. Pursuant to Conn. Gen Stat §49-51 and § 52-380d, the undersigned hereby fully and completely discharges and releases said lien. This the _____ day of _______________ , 20 _____ . ________________________________ Company Name By: _________________________________ _____ Signature Title ________________________________ Type or Print Name Discharge and Release of Lien Page 1 of 2 ________________________ Witness ________________________ Witness Attest: Secretary Acknowledgment for Corporation or LLC State of Connecticut County of ________________________ On this the ______________ day of ______________, ______________, before me, a Notary Public, personally appeared __________________________________________ (Name of Officer) who acknowledged himself/herself to be the ________________________ (Title of Officer) of ____________________________ (Name of Company), a ________________, and that he/she, as such ____________________________ (Title of Officer), being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself/herself as ____________________________ (Title of Officer). In witness whereof I hereunto set my hand. Date:___________________________ ______________________________ Notary Public Print Name: ___________________ My Commission Expires: _____________________ Discharge and Release of Lien Page 2 of 2