Fill and Sign the Initials 1 Ga Form 5 Interim Waiver and Release Upon

Waiver and Release Upon Final Payment Page 1 of 2 After Recording Return to: WAIVER AND RELEASE UPON FINAL PAYMENT [INDIVIDUAL] STATE OF GEORGIA COUNTY OF _________________ THE UNDERSIGNED MECHANIC AND/OR MATERIALMAN HAS BEEN EMPLOYED BY __________________________________ (NAME OF CONTRACTOR) TO FURNISH ___________________________________ (DESCRIBE MATERIALS AND/OR LABOR) FOR THE CONSTRUCTION OF IMPROVEMENTS KNOWN AS ________________________________ (TITLE OF THE PROJECT OR BUILDING) WHICH IS LOCATED IN THE CITY OF _____________________, COUNTY OF __________________________________, AND IS OWNED BY __________________________________ (NAME OF OWNER) AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: [FULL LEGAL DESCRIPTION - DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT NUMBER, OR STREET ADDRESS OF THE PROJECT.] UPON THE RECEIPT OF THE SUM OF $________________________, THE MECHANIC AND/OR MATERIALMAN WAIVES AND RELEASES ANY AND ALL LIENS OR CLAIMS OF LIENS IT HAS UPON THE FOREGOING
And states that the following conditions have been fulfilled to his satisfaction: waiver and release upon final payment page 2 of 2 after recording return to: [individual] state of georgia county of the undersigned mechanic and/or material man has been employed by (name of contractor) to furnish materials and/or labor for (names of materials and/or labor and/or description for each) which is located in (dotted line) city of and is owned by (name of owner)? [materialman], upon the receipt of the sum of for such work (including the amount of time expended in preparing such work for use as listed) he waives and releases any and all liens or claims of liens that it has upon the foregoing, states that he will furnish said goods, materials and/or labor to the owner for the use stated, and that upon final payment for any of the materials used for such work he will release said material man from all claims, liens or encumbrances theretofore incurred by the owner in regard to such goods, materials, and labor or to the services of the said material man, and further waives and releases and agrees to release any and all liens or claims, liens or claims of liens of the owner prior to such goods, materials, or labor being utilized by the owner upon the return of any such work, and further states that in case said mechanic and/or material man of such work has in good faith previously entered into or executed a certificate on a form to be prescribed by the city and county clerk of the county of (city and county of the person entering such application), and has in good faith made payment of the said sum of or has in good faith previously executed a lease or a contract on a form to be prescribed by the county and city clerk of the county of, and which agrees to the payment of the said amount, the owner shall not be required to produce to the city and county clerk of the county in the same manner and form as described in the preceding sentence. [individual] the city and county clerk of the city and county to whom such certificate or lease or contract was tendered or executed [name of crown or city of crown] section 14.