Fill and Sign the Notice of Satisfaction Individual Missouri Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: _____________________ Company: ___________________ Address: _____________________ City: _____________________ State: _____ Zip: __________ Phone: ________________ Fax: _________________ NOTICE OF SATISFACTION OF LIEN--INDIVIDUAL ( M.A.S. § 429.120) On this the _____ day of _______________ , 20 ______ , the undersigned does hereby acknowledge receipt of payment from __________________________________ in the amount of $ ______________ which represents payment in full for labor performed and/or materials furnished by _________________________________ for the following improvements ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ to the property located at: _______________________________________________________________________ . By this document the undersigned lien claimant hereby releases any lien it may have in connection with the above - described property for labor performed and materials furnished. __________________________________ Signature of Lien Holder _____ _____________________________ Type or Print Name STATE OF MISSOURI COUNTY OF _______________ On this _____ day of ________________ , 20 ______ , before me personally appeared __________________________________ , to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed the same as his/her free act and deed. Notice of Satisfaction of Lien Page 1 of 2 IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal in the county and state aforesaid, the day and year first above written. ______________________________ Notary Public My commission expires: ________________ Notice of Satisfaction of Lien Page 2 of 2