Fill and Sign the Florida Release Lien Form

Waiver and Release of Lien Page 1 of 2 Prepared by, recording requested by and return to: ---------------------- Above this Line for Official Use Only --------------------- Name: ___________________ Company: ___________________ Address: _____________________ City: __________________________ State: _____ Zip: _____________ Phone: _____________________ Fax: _______________________ WAIVER AND RELEASE OF LIEN UPON FINAL PAYMENT- INDIVIDUAL The undersigned lienor, in consideration of the final payment in the amount of $ __________________, hereby waives and releases its 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 the following described property: ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. DATED on _____ day of ___________________, 20 _____. Lienor's Name _________________________ Address _______________________________ By _________________________ Printed Name __________________________ Waiver and Release of Lien Page 2 of 2 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 _________________________