Fill and Sign the Florida Lien Template Form

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--------------------- RELEASE OF LIEN- INDIVIDUAL STATE OF FLORIDA COUNTY OF___________________. KNOW ALL MEN BY THESE PRESENTS: THE UNDERSIGNED, for and in consideration of the payment of the sum of $ ___________________, paid by _______________________, the receipt of which is hereby acknowledged, by these presents does hereby waive, release, and quit-claim all liens, lien rights, claims or demands of every kind whatsoever against _____________________________ which the undersigned now has or may hereafter have, including without limitation, that certain Claim of Lien recorded in Official Record Book __________, Page ________, of the Public Records of ___________________ County, Florida, against that certain real estate and the improvements located thereon, situated in _____________________ County, Florida, and described as follows: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ (legal description) on account of work and labor performed, and/or materials furnished in improving said above-described property, or any part thereof. The undersigned certifies that all labor, services and/or materials described herein have been provided prior to the execution and delivery of this document. Release of Lien Page 2 of 2 WITNESS my hand and seal this _____ day of __________________, 20 _____. Lienor's Name _________________________ Address ____________________________________________________________________ By __________________________________ Signature Printed Name _________________________ STATE OF ___________ COUNTY OF _____________ Sworn to (or affirmed) and subscribed before me this _____ day of _________________, 20______ by _________________________ (name of person making statement) who is personally known to me or produced _________________________ as identification, and who did take an oath. ____________________________ NOTARY PUBLIC Printed Name of Notary _________________________ Commission Expires _________________________