Fill and Sign the Final Waiver and Affidavit Ticor Title Form

Final Lien Waiver Page 1 of 2 FINAL LIEN WAIVER STATE OF ILLINOISCOUNTY OF ________________ ____________________, 20_____ TO ALL WHOM IT MAY CONCERN: Whereas, the undersigned, __________________________________ , has been employed by ____________________________________, contractor of _________________________________, the owner of the premises, hereinafter described to furnish ______________________________________ for the said premises, which are known as _________________________________, in County of ____________________, Illinois, and which are also described by legal description as: _______________________________________________________________________ in the County of _______________, State of Illinois; Now, therefore, the undersigned, for and in consideration of the sum of ________________ Dollars, and other good and valuable considerations, the receipt whereof is hereby acknowledged by the undersigned, do hereby waive and release any and all lien or claim of, or right to, lien, under the statutes of the State of Illinois, relating to mechanics' liens, with respect to and on said above-described premises, and the improvements thereon, and on the material, fixtures, apparatus or machinery furnished, and on the moneys, funds or other considerations due or to become due the contractor from the owner, on account of labor, services, material, fixtures apparatus or machinery heretofore furnished, or which may be furnished at any time hereafter, by the undersigned, to or on account of the said contractor of the said owner, for the above- described premises. _________________________ Signature_________________________Print or Type Name Final Lien Waiver Page 2 of 2State of _____________________County of ___________________Given under the hand and seal of the undersigned, this ____ Day of ________, 20___. _____________________________ Notary Public (SEAL) Printed Name: _________________ My Commission Expires: _____________________