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- #4900
- @001 Enter the name of the party releasing the lien:
- @002 Enter the name of the party against whom lien was filed:
- @490 Enter the State where release signed:
- @491 Enter the County where release signed:
- @492/@492/@492 Enter reason for lien:
- provision of services
- provision of materials
- KEY IN VALUE
- @493 Enter description of job liened:
- @494 Enter name of the owner of property liened:
- #4901 Was the lien recorded?
- #if#4901
- @495 Enter title of book where recorded:
- @496 Enter the pages where recorded:
- @497 Enter records where recorded:
- @498 Enter county where recorded:
- @499 Enter state where recorded:
- #endif
- #4902
- #end control section
- #4900
- /* Para. 4900: Release of mechanic's lien */
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- RELEASE OF LIEN
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- STATE OF @490)
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- COUNTY OF @491)
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- @001, being duly sworn to tell the truth states that by virtue of
- @492 provided to @002, at @493, claimed a lien on the property of
- @494.
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- Having received full satisfaction thereof, @001 consents to
- release of the lien.
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- #4901
- /* Para. 4901: Recorded lien */
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- Said lien having been recorded in @495 Book, Page @496 of the
- @497 records of @498 County, @499.
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- #4902
- /* Para. 4902: Close release of lien */
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- Dated: ____________________
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- _____________________________________________
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- @001
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- Sworn to and subscribed before me on ________________, 19_______.
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- ____________________________________________
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- Officer
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- Title: ________________________
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