Fill and Sign the Statutory Appendix Table of Contents State Page Form

Demand for Acknowledgment of Satisfaction – IndividualPage 1 of 2Prepared by: After Recording, Return to: (Full Name of Party) (Company, if applicable) (Street Address) (City, State and Zip Code) DEMAND FOR ACKNOWLEDGEMENT OF SATISFACTION - INDIVIDUAL (Ala. Code § 35-11-231) COMES NOW, , as a party with an interest in the improved property described as: See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description: and would state as follows:1.On or about , a Verified Statement of Lien in the amount of (date) $ , was filed against the above mentioned property.2.Said lien was in the favor of: (Signature Lien Claimant) (Type or Print Name) (Street Address) (City, State, Zip Code) 3. Said lien was fully satisfied on . (date) 4.Pursuant to Ala. Code § 35-11-231(b), the undersigned hereby demands that the above- named lien claimant provide an acknowledgement of satisfaction of said lien within thirty (30) days of receipt of this demand or be held liable to any person injured as a result of the lien claimant’s failure to provide said acknowledgement. Demand for Acknowledgment of Satisfaction – IndividualPage 2 of 2Date: (Signature) (Type or Print Name) (Street Address) (City, State, Zip Code) Certificate of Delivery I, , hereby certify that I have delivered this day a true and correct copy of the foregoing to by: Personal Service with signed receipt Mailing a true and correct copy of same by first-class U.S. mail, postage prepaid, return signed receipt requested to: (Name) (Street Address, City, State, Zip Code) Other (specify) So certified this the day of , 20 . (Signature) (Type or Print Name)