VA Waiver of Liens

WAIVER OF LIENS

 

DATE:  _________________________        Original Contract Amount $________________________

                                                               Previous Payments:              $________________________

                                                               Current Payments:                $________________________

                                                               Contract Balance:                 $________________________

                                                                Less Retention:                     $________________________

 

STATE OF VIRGINIA_______________________,

COUNTY/CITY OF _________________________; to wit:

 

 

KNOW ALL MEN THAT__________________________________________________________,

for and in consideration of, the sum of ________________________________________________________,

in payment of invoice or application dated ____________________________________________________ ,

does hereby waive, release and relinquish any and all claims of lien which ___________________________,

_________________ now has upon the premises known and described as [insert legal description]________

_______________________________________________________________________________________,

for labor, materials and services furnished prior to_______________________________________________ ;

said premises being owned by ______________________________________________________________.

 

 

            By:___________________________________

 

Subscribed and sworn to before me this ______ day of _____________________________, 201___.

 

 

                                                                                           _________________________________________

Notary Public

 

 

                My Commission Expires:  ___________________.

No guidelines are available for this form at this time.