Mechanics Lien Release Agreement Form

Mechanics Lien Release Agreement Form
Complete this Mechanics Lien Release Agreement Form to provide all required information for processing a mechanics lien release. Please ensure all details are accurate and complete.
Claimant/Contractor Name
Property Owner or General Contractor Name
Property or Project Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Project Description
Lien Claim Amount
Lien Recording or Reference Number
Payment/Release Status
Effective Date of Release
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Acknowledgment and Release Statement: By submitting this form, the claimant/contractor affirms that the above information is true and accurate, and hereby releases the mechanics lien on the described property/project as of the effective date.
Signature of Claimant/Contractor
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