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Fill and Sign the Final Waiver of Lien Contractors Affidavit Title Services Inc Form

Fill and Sign the Final Waiver of Lien Contractors Affidavit Title Services Inc Form

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Partial Lien Waiver Page 1 of 2 PARTIAL 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 the _________________ of _________________, 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 to the extent only of the aforesaid amount of Dollars, paid simultaneously herewith, the lien of right to, or claim of, 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, furnished by the undersigned, to the extent only of the aforesaid payment, to or on account of the said contractor or the said owner, for the above-described premises. _________________________ Signature_________________________Print or Type Name Partial 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: _____________________

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