(Tab to move through the fields. Use the space bar to put an “X” in a box.) Fill out on screen; then print, sign, and fax back to 612-337-2471 or mail to address below.
RECEIPT AND WAIVER OF MECHANIC’S LIEN RIGHTS
Date: The undersigned hereby acknowledges receipt of the sum of $ For: PARTIAL PAYMENT for material, labor or service FULL AND FINAL PAYMENT for material, labor or service
Furnished to the following described property for work completed through: (enter date).
Project Name: Legal Desc: General Contractor: Project Manager: File No: Contract Amount: $
and for value received hereby waives any and all rights to file a mechanic’s lien against said property for material, labor or service furnished to said property. The undersigned affirms that all materials and labor furnished on behalf of the undersigned have been paid in full EXCEPT: (List unpaid items here, or state None.)
Return this Lien Waiver to: Commercial Partners Title, LLC 200 So. Sixth Street, Suite1300 Minneapolis, MN 55402 Fax: 612-337-2471
By:
Signature
Title: Address: Phone No.