Fill and Sign the Job of Owner of Property to the Following Form

Conditional Waiver and 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--------------------- CONDITIONAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT On this _____ day of ________________, 20______, the undersigned lienor, in consideration of the sum of $ ___________________, does hereby waive and release his or her 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: ________________________________________________________________________________________________________________________________________________ ___________________________________________________________________ (if using the description contained in or shown by one or more maps, plats, descriptions, deeds, mortgages or other instruments of record in the office of the county clerk of the county in which the affected real estate is located, the description must include the time and place of filing or recordation of the instrument containing the description referred to, or other similar information, to locate and identify the instrument containing the description). This Conditional Waiver and Release of Lien Upon Progress Payment is conditioned upon the undersigned receiving collected funds in the amount of $_______________ for the work described herein. Should these funds not be received within _____ days of the date hereof, this Conditional Waiver and Release of Lien is void. This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified. __________________________________ Signature of Lien Holder__________________________________ Type or Print Name Conditional Waiver and Release of Lien Page 2 of 2 State of New Mexico County of __________________ This instrument was acknowledged before me, on the ______ day of __________________, 20______, by ____________________________________. (SEAL) Notary Public My commission expires: Type or Print Name