Fill and Sign the Release of Lien Corporation Llc Etc Form

Release of Lien Page 1 of 2Prepared by, recording requested by and return to:Name: ________________________Company: _____________________Address: ______________________City: _________________________State: ______Zip: __________Phone: _______________________Fax: _______________________----------------------Above this Line for Official Use Only--------------------- RELEASE OF LIEN-Corporation, LLC, etc. On this _____ day of ___________ , 20______, as representative of __________________________________ a _________________________________ business entity does hereby acknowledge receipt of payment from __________________________________ in the amount of $____________________ which represents full payment for labor performed and materials furnished by ____________________________________ in reference to the work on the following described property: ____________________________________.___________________________________ hereby releases any lien it may have in connection with the above-described work including any lien for labor performed and materials furnished.___________________________________Name of CompanyBy: _________________________________ _____ Signature Title ___________________________________Type or Print NameAttest: Secretary State of ____________________ County of ____________________On this _________ day of ____________________, 20________, before me, __________________________________, a Notary Public, (or before any officer within this State or without the State now qualified under existing law to take acknowledgments), duly commissioned, qualified and acting, within and for said County and State, appeared in person the within named ___________________________________and ___________________________________, (being the person or persons authorized by said corporation, [business trust, estate, partnership, limited liability company, association, joint venture, or other legal entity] to execute such instrument, stating their respective capacities in that behalf), to me personally well known (or satisfactorily proven to be such person), who stated that _________ [he, she, or they] was [were] the ___________________________________ [and _________] of the ___________________________________, a corporation, [business trust, estate, partnership, limited liability company, association, joint venture, or other legal entity], and was [were] duly authorized in __________[his, her, or their] respective capacity [capacities] to execute the foregoing instrument(s) for and in the name and behalf of said corporation, [business trust, estate, partnership, limited liability company, association, joint venture or other legal entity], and further stated and acknowledged that[he, she, or they] had so signed, executed, and delivered said foregoing instrument for the consideration, uses, and purposes therein mentioned and set forth. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal this _________ day of ___________________________________, 20_________. _____________________________________________(Notary Seal)(Notary Public)