Fill and Sign the Full Conditional Waiver 481379854 Form

Full Conditional Waiver of Lien Page 1 of 1 FULL CONDITIONAL WAIVER OF LIEN --INDIVIDUAL (M.S.A. § 570.1115(9)(d)) My/our contract with _______________________________ to provide ________________________________________________________________________ (description of work and/or materials) for the improvement of the property described as ________________________________________________________________________ has been fully paid and satisfied. By signing this waiver, all my/our construction l ien rights against the described property are waived and released. This waiver is conditioned on actual payment of $______________. If the improvement is provided to property that is a residential structure and if the owner or lessee of the property or the owner's or lessee's designee has received a notice of furnishing from me/one of us or if I/we are not required to provide one, and the owner, lessee, or designee has not received this waiver directly from me/one of us, the owner, lessee, or designee may not rely upon it without contacting me/one of us, either in writing, by telephone, or personally, to verify that it is authentic. This the _____ day of _____________, 20_______. ________________________ Lien Claimant ________________________ Type or Print Name ________________________ ________________________ Address ________________________ Telephone DO NOT SIGN BLANK OR INCOMPLETE FORMS. RETAIN A COPY . MI § 570.1115