Unconditional Lien Waiver and Release on Final Payment
Generic template for projects in states without a statutory waiver form. Not legal advice.
Claimant (name of the party signing and giving up lien rights)
Customer (party paying the claimant)
Property owner
Project name
Job number / PO / subcontract number
Project address or legal description
Final payment amount received ($)
The Claimant has been paid in full for all labor, services, equipment and materials furnished to the project described above.
The Claimant unconditionally waives and releases any mechanic’s lien, stop notice, bond or payment right it has on the project, including retention, change orders and extra work, except for the disputed claims listed under Exceptions.
Exceptions (disputed claims NOT waived, with amounts):
Notice to claimant: this document waives rights unconditionally and states that you have been paid. Do not sign it if you have not been paid. If you have not been paid, use a conditional waiver.
Claimant’s company name
Signature
Printed name and title
Date signed