Fill and Sign the Release Liability Ks Form

Prepared by, recording requested by and return to: ----------------------Above this Line for Official Use Only---------------------Name: Company: Address: City: State: Zip: Phone: Fax: RELEASE OF LIEN --CORPORATION (Kan. Stat. Ann. § 60-1103b(d)) 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 or about the ____ day of ______________, 20____, the undersigned filed a notice of intent to provide labor and/or materials for the construction of the above described new residential property. 2. Payment in full was made to the undersigned on the _____ day of ___________________, 20____. 3. The undersigned would hereby state that it is the intention of the undersigned lien claimant to waive or relinquish any statutory right to a lien for the furnishing of labor or material to said property. This the ____ day of ____________________, 20____. ______________________________ Signature ______________________________ Title ______________________________ Corporation Release of Lien Page 1 of 2 Acknowledgment of Corporation STATE OF KANSAS COUNTY OF ___________________ This instrument was acknowledged before me on __________________________ (date) by ___________________________________________ [name(s) of person(s)] as _____________________________________________________ (type of authority, e.g., officer, trustee, etc.) of _____________________________________ (name of party on behalf of whom instrument was executed.) _____________________________ Notary Public Print Name: ___________________ My commission expires: _____________________ KS § 60-1103b(d) Release of Lien Page 2 of 2