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U.S. Department of Agriculture Rural Utilities Service
WAIVER AND RELEASE OF LIEN
WHEREAS the undersigned,
NAME OF MANUFACTURER, MATERIAL SUPPLIER OR SUBCONTRACTOR
has furnished to
NAME OF CONTRACTOR
the following: for
KIND OF MATERIAL AND SERVICES FURNISHED
use in the construction of a project belonging to
NAME OF BORROWER
and designated the Rural Utilities Service as
RUS DESIGNATION
NOW, THEREFORE, the undersigned,
NAME OF MANUFACTURER, MATERIAL SUPPLIER, OR SUBCONTRACTOR
and other good and valuable for and in consideration of $ consideration, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all liens, or right to or claim of lien, on the above described project and premises, under any law, common or statutory, on account of labor or materials, or both, heretofore or hereafter furnished by the undersigned to or for the account of said
NAME OF CONTRACTOR
for said project .
Given under my (our) hand(s) and seal(s) this
day of
,20
.
Name of Manufacturer, Material Supplier, or Subcontractor
By President
This Waiver and Release of Lien must be signed with the full name of the Manufacturer, Material Supplier, or Subcontractor. If the Manufacturer, Material Supplier, or Subcontractor is a partnership, this Waiver and Release of Lien must be signed in the partnership name by a partner. If the Manufacturer, Material Supplier, or Subcontractor is a corporation, this Waiver and Release of Lien must be signed in the corporate name by a duly authorized officer and the corporate seal affixed and attested by the Secretary of the Corporation.
RUS FORM 224 (Rev. 2-04)