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 ______________________________________________________________.
Subscribed and sworn to before me this ______ day of _____________________________, 201___.
My Commission Expires: ___________________.
No guidelines are available for this form at this time.