RELEASE OF MECHANICS LIEN
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Neither the publisher nor the seller of this form makes any warranty
With respect thereto, including any warranty of merchantability or
Fitness for a particular purpose.
KNOW ALL MEN BY THESE PRESENTS, THAT
____________________________________, of the County
of ______, State of Illinois, for and in consideration of Ten
and No/100 ($10.00) DOLLARS, and for other good and
valuable consideration, and the payment in full of alls sums
owed it by ___________________, the receipt of which is
hereby acknowledged, does hereby remise, release, convey
and quit claim unto ____________________________, of
_____________, ____________________, its agents, legal
representatives, and assigns, all the right, title, interest,
claim or demand whatsoever _______________. may have
acquired in, through, or by that certain Subcontractors
Claim for Lien dated _____ day of ____________, 20 ___
and recorded in the Recorder’s Office of _______ County,
in the State of Illinois, as Document Number
_________________ ___to the premises therein described,
situated in the County of _____________, State of Illinois,
as follows, to wit:
Permanent Real Estate Index Number(s): _________________________
Address of Property: _________________________________________
WITNESS my hand and seal this ___ day of ___________, 20___
.
BY:________________________________________________
STATE OF ILLINOIS ) SS
COUNTY OF _______ )
I, the undersigned, a Notary Public in and for said County, in the State aforesaid, DO HEREBY CERTIFY that
__________________________., ___________ of _________________ a __________________, personally
known to me to be the same person whose name is subscribed to the foregoing instrument, appeared before me
this day in person, acknowledged that (s) he signed, sealed and delivered the said instrument as his free and
voluntary act, and as the free and voluntary act of ______________. for the uses and purposes therein set forth.
Given under my hand and official seal, this ____ day of __________, 20___
.
_____________________________________ (NOTARY PUBLIC)
PREPARED BY: MAIL RECORDED ORIGINAL TO:
__________________
__________________
__________________