Fill and Sign the North Carolina Llc Search Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: Company: Address: City: State: Zip: Phone: Fax: Acknowledgement of Satisfaction – Corporation (N.C. Gen. Stat. § 44A-16) COMES NOW, _______________________________, as a representative of _______________________ a _______________________ corporation which has provided labor and/or materials for the improvement of the property located at and described as __________________________________________________________ _____________________________________________________________________, and would state as follows: 1. On the _____ day of _________________, 20_____ the undersigned recorded a lien statement claiming a lien in the amount of $____________________. Acknowledgement of Satisfaction Page 1 of 3 2. The undersigned lien claimant hereby acknowledges the satisfaction of said lien indebtedness by payment in full on or about the ____ day of ______________, 20____. This the _____ day of ______________, 20____. ________________________________ Lien Claimant ________________________________ Title ________________________________ Corporation ________________________________ Witnessed by Clerk of the Superior Court Acknowledgement of Satisfaction Page 2 of 3 Acknowledgment of Corporation STATE OF NORTH CAROLINA COUNTY OF _____________________ I, ____________________________________ (Name of officer taking acknowledgment), ________________________________________ (Official title of officer taking acknowledgment) certify that ____________________________________ (Name of attesting official) personally came before me this day and acknowledged that he/she is ____________________________________ (Title of attesting official) of ____________________________________, a corporation, and that by authority duly given and as the act of the corporation, the foregoing instrument was signed in its name by its __________________, (Title of Official), sealed with its corporate seal, and attested by himself (or herself) as its ____________________________________ (Title of attesting official). Witness my hand and official seal, this the ____________ day of __________________, (Month) __________________ (Year) _____________________________ Notary Public Printed Name: _________________ My Commission Expires: _____________________ Acknowledgement of Satisfaction Page 3 of 3