Fill and Sign the Texas Lien 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 CONFIDENTIALITY RIGHTS: IF YOU ARE A NATURAL PERSON, YOU MAY REMOVE OR STRIKE ANY OF THE FOLLOWING INFORMATION FROM THIS INSTRUMENT BEFORE IT IS FILED FOR RECORD IN THE PUBLIC RECORDS: YOUR SOCIAL SECURITY NUMBER OR YOUR DRIVER’S LICENSE NUMBER. WAIVER AND RELEASE OF LIEN BY CLAIMANT--CORPORATION The undersigned’s contract with       (other contracting party) to provide       for the improvement of the property described as: SEE ATTACHED LEGAL DESCRIPTION AND PLAT having been fully paid and satisfied, all the undersigned’s construction lien rights against such property are hereby waived and released. Signed on the _____ day of _______________ , 20 _____ . DO NOT SIGN BLANK OR INCOMPLETE FORMS. RETAIN A COPY. Waiver and Release of Lien by Claimant Page 1 of 3 Subscribed and sworn to this ______ day of ____________ , 20 _____ , at _______________ , ______ . Signature and Acknowledgment of Corporation By:       Print Name:       Its:       Title Attest: Corporate Secretary Print Name:       STATE OF TEXAS COUNTY OF       This instrument was acknowledged before me on ______(date)______ by ______(name of officer)______ , ______(title of officer)______ of (name of corporation acknowledging) a (state of incorporation) corporation, on behalf of said corporation. Notary Public Printed Name:       My Commission Expires:       Waiver and Release of Lien by Claimant Page 2 of 3 Certificate of Delivery I,       , hereby certify that I have delivered this day a true and correct copy of the foregoing to       by: Hand Delivery Mailing a true and correct copy of same by Certified or Registered U.S. Mail, postage prepaid, to       , at his/her usual place of business located at       . So certified this the ______ day of _________________ , 20 _____ . Signature TX Code § 53.152 Waiver and Release of Lien by Claimant Page 3 of 3