Mechanics Lien Release Form
Recording Requested by:
Please Return To:
SPACE ABOVE FOR RECORDER’S USE
CLAIMANT (Give name & address)
Recorded ____ /_____ /20____
Book ________ Page _________
Property Liened (Property) (Give municipal address & legal description)
Property Owner (Owner) (Give name & address)
Notary: On the ____ day of ____________, 20____, In the State of ______________, County of ______________, ________________, Agent for Claimant, personally came and appeared before me, and executed this instrument in the agent’s stated capacity, with proper authority from the Claimant.
Signed this ____ day of _________________, 20____.
Agent for Claimant