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Fill and Sign the This Waiver and Release Does Not Cover Any Retention or Labor Services or Form

Fill and Sign the This Waiver and Release Does Not Cover Any Retention or Labor Services or Form

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Prepared by, recording requested by and return to: Name: ___________________ Company: ___________________ Address: ____________________ City: ___________________ State: _____ Zip: __________ Phone: _________________ Fax: __________________ ----------------------Above this Line for Official Use Only--------------------- UNCONDITIONAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT On this _____ day of ________________, 20______,the undersigned lienor, whose address is ______________________________________________________________________, in consideration of the sum of $ __________________, hereby waives and releases his or her lien and right to claim a lien for labor, services or materials furnished through ____________________, 20_____, to ___________________________________ (customer) on the job of __________________________________ (owner of property) to property located at and described as: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified. ______________________________ Signature of Lien Holder______________________________ Type or Print Name This instrument was prepared by _______________. STATE OF WEST VIRGINIA COUNTY OF ________________ This instrument was acknowledged before me on ________________ (date) by _________________________________ (name or names of person or persons acknowledging). _________________________ Notary Public Printed Name: ____________________ My Commission Expires: _______________

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  4. Click Me (Fill Out Now) to prepare the document on your end.
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The best way to complete and sign your this waiver and release does not cover any retention or labor services or form

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How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device

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How to Sign a PDF on iPhone How to Sign a PDF on iPhone

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