#4900
@001 Enter the name of the party releasing the lien:
@002 Enter the name of the party against whom lien was filed:
@490 Enter the State where release signed:
@491 Enter the County where release signed:
@492/@492/@492 Enter reason for lien:
provision of services
provision of materials
KEY IN VALUE
@493 Enter description of job liened:
@494 Enter name of the owner of property liened:
#4901 Was the lien recorded?
#if#4901
@495 Enter title of book where recorded:
@496 Enter the pages where recorded:
@497 Enter records where recorded:
@498 Enter county where recorded:
@499 Enter state where recorded:
#endif
#4902
#end control section
#4900
/* Para. 4900: Release of mechanic's lien */

                         RELEASE OF LIEN


STATE OF @490)

COUNTY OF @491)


@001, being duly sworn to tell the truth states that by virtue of
@492 provided to @002, at @493, claimed a lien on the property of
@494.


Having received full satisfaction thereof, @001 consents to
release of the lien.


#4901
/* Para. 4901: Recorded lien */

Said lien having been recorded in @495 Book, Page @496 of the
@497 records of @498 County, @499.


#4902
/* Para. 4902: Close release of lien */

Dated: ____________________





_____________________________________________

@001


Sworn to and subscribed before me on ________________, 19_______.




____________________________________________

Officer



Title: ________________________