Fill and Sign the Waiver of Lien Individual Form

Waiver of Lien Page 1 of 2 WAIVER OF LIEN-INDIVIDUAL (A.S. § 34.35.117) COMES NOW, ___________________________________, as a party who has claimed a lien for labor, materials, services, or equipment provided for the improvement of the property located at __________________________________, and would state as follows: 1. The undersigned has been paid in full for all labor, materials, services, or equipment furnished to the jobsite or to __________________________________, person with whom the undersigned contracted, on the job of _________________________________, owner, located at __________________________________. 2. The undersigned is not an employee of the owner or any contractor furnishing labor, materials, services, or equipment for the improvement of the property described above. 3.Pursuant to Alaska Statute § 34.35.117, the undersigned does hereby waive and release any right to a mechanic's lien relating to the labor, materials, services, or equipment provided for the improvement of the property described above. 4.This Waiver requires no consideration and is valid and binding but may not relate to labor, materials, services, or equipment furnished after the date it is signed. This the _____ day of __________, 20______._________________________Signature_________________________Print or Type Name Verification I _______________________________ say on oath or affirm that I have read the foregoing (or attached) document and believe all statements made in the document are true. ______________________ Signature Waiver of Lien Page 2 of 2State of Judicial District (or County) of or Municipality of The foregoing instrument was acknowledged before me this _________________________ (date) by ________________________________________(name of person who acknowledged).______________________________________Signature of Person TakingAcknowledgment__________________Title or Rank My Commission Expires: __________________Serial Number, if any ________________________