Missouri Mechanics Lien Release Form

Missouri Construction or Mechanics Lien Information Form

Contractor Information

Contractor Name (Corporation, LLC or Partnership):

Contractor Address:

Contractor Phone:

Project and Owner Information (for Notice to Owner)

Property Owner Name:

Property Address:

Legal Description of Property (if known):

Date of Notice to Owner (if applicable):

Lien Claim Details

Description of Labor, Materials, or Machinery Provided:

Total Amount Due for Services/Materials:

Date Indebtedness Accrued:

Date Lien Claim Filed (if applicable):

Affidavit of Contractor Certifying Subcontractors Have Been Paid

I certify that all subcontractors, laborers, or materialmen for this project have been paid in full, except as listed below.

List of Unpaid Subcontractors/Materialmen (if any):

Assignment of Lien (if applicable)

Assignor Name (Current Lienor):

Assignee Name (Party receiving the lien):

Date of Assignment:

Signature