Fill and Sign the Unconditional Waiver and Release Upon Final Payment Sect 44 14 366 Individual Georgia Form

After Recording Return to:                         WAIVER AND RELEASE UPON FINAL PAYMENT [INDIVIDUAL] STATE OF GEORGIA COUNTY OF _________________ THE UNDERSIGNED MECHANIC AND/OR MATERIALMAN HAS BEEN EMPLOYED BY __________________________________ (NAME OF CONTRACTOR) TO FURNISH ___________________________________ (DESCRIBE MATERIALS AND/OR LABOR) FOR THE CONSTRUCTION OF IMPROVEMENTS KNOWN AS ________________________________ (TITLE OF THE PROJECT OR BUILDING) WHICH IS LOCATED IN THE CITY OF _____________________ , COUNTY OF __________________________________ , AND IS OWNED BY __________________________________ (NAME OF OWNER) AND MORE PARTICULARLY DESCRIBED AS FOLLOWS:       [FULL LEGAL DESCRIPTION - DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT NUMBER, OR STREET ADDRESS OF THE PROJECT.] UPON THE RECEIPT OF THE SUM OF $ ________________________ , THE MECHANIC AND/OR MATERIALMAN WAIVES AND RELEASES ANY AND ALL LIENS OR CLAIMS OF LIENS IT HAS UPON THE FOREGOING Waiver and Release Upon Final Payment Page 1 of 2 DESCRIBED PROPERTY OR ANY RIGHTS AGAINST ANY LABOR AND/OR MATERIAL BOND ON ACCOUNT OF LABOR OR MATERIALS, OR BOTH, FURNISHED BY THE UNDERSIGNED TO OR ON ACCOUNT OF SAID CONTRACTOR FOR SAID PROPERTY. GIVEN UNDER HAND AND SEAL THIS _____ DAY OF __________________ , _______ . (Seal)       Type or Print Name (Witness)       Type or Print Name       Street Address       City, State and Zip NOTICE: WHEN YOU EXECUTE AND SUBMIT THIS DOCUMENT, YOU SHALL BE CONCLUSIVELY DEEMED TO HAVE BEEN PAID IN FULL THE AMOUNT STATED ABOVE, EVEN IF YOU HAVE NOT ACTUALLY RECEIVED SUCH PAYMENT, 60 DAYS AFTER THE DATE STATED ABOVE UNLESS YOU FILE EITHER AN AFFIDAVIT OF NONPAYMENT OR A CLAIM OF LIEN PRIOR TO THE EXPIRATION OF SUCH 60 DAY PERIOD. THE FAILURE TO INCLUDE THIS NOTICE LANGUAGE ON THE FACE OF THE FORM SHALL RENDER THE FORM UNENFORCEABLE AND INVALID AS A WAIVER AND RELEASE UNDER O.C.G.A. SECTION 44-14-366. Reference: 44 - 14 - 366. Waiver and Release Upon Final Payment Page 2 of 2