Lien Waiver Form

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Lien Waiver Form Download

To download the free lien waiver form in PDF format, please click Lien Waiver Form in the bottom.

STATE OF____________________
COUNTY OF__________________
I, _____________________________ of _____________________________________________, being sworn, says he is the ____________________of ____________________________________________ (hereinafter referred to as the “Contractor” has finished all materials, labor, tools, equipment, construction facilities and everything of every sort and has performed all work required by the contract entered into with Public Storage, 701 Western Avenue, Glendale, CA 91201 (hereinafter referred to as “PS”) dated the _____day of ______________, 20___ pertaining to:
Property Address work performed at:________________________________________________________________________
Description of Work: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
The contractor has fully paid for all said materials, labor, tools, equipment, construction facilities and everything of every sort furnished by it, or by its subcontractors or material men, upon said premises and furnished therefore for said work.
The current amount due from PS, and unpaid to Contractor, is the sum of $______________, and upon payment to the Contractor of said sum, Contractor hereby waives all liens and claims against PS, its premises and property for said sum, and further, Contractor represents that no other person or party has right to a lien on account of any work performed for, or material furnished to Contractor for said work.
By: ___________________________________________________________
Contractors Federal Tax ID # ________________________________
Sole Proprietor Social Security # _____________________________
BEFORE ME, the undersigned authority, on this day personally appeared ____________________ known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he executed the same for purposes and consideration therein expressed, GIVEN under my hand and seal of office, this _____ of ______________, 20___.
My commission expires ____________ NOTARY PUBLIC: ____________________

To download the lien waiver form, please click Lien Waiver Form.

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