Letter for Partial Release of Lien

Letter for Partial Release of Lien : Please fill out the following form. Please print your completed form if you would to have a copy for your records.


That the undersigned, for and in consideration of the payment of the sum of (AMOUNT) Dollars ($________) paid by (Name who pays the debts), receipt of which is hereby acknowledged, hereby releases (Name of the property which is released) dollars ($____) from the amount due under its lien against the following described premises :

Enter the address of the premises.

on account of labor performed and/or materials furnished for the improvement of the above described premises. This partial release does not release the lien or the lien rights which undersigned has or may acquire because of labor performed or materials furnished for the improvement of the above described premises and any such lien or lien rights shall relate to and take effect from the date of recording the NOTICE OF COMMENCEMENT or NOTICE TOOWNER provided under applicable state law.

IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of (date with year).

Signed in the presence of :

Lienholder :

Lienholder :

Witness :

Date :



On _______________________ before me _________________________ personally appeared ___________________________ personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

WITNESS my hand and official seal.

Signature :

Affiant : Known / Unknown :

ID Produced :

Seal :

Letters Used in Real Estate Index

Letter for Partial Release of Lien

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