How to fill out this form.
  1. This form must be completed and signed by each contractor you use.
  2. The dollar amount on this form must match the dollar amount on the contractor’s contract.
  3. As the borrower, complete and sign the bottom portion of each form.
  4. Return all completed original forms to us.
Tel:
Fax:

CONDITIONAL WAIVER OF LIEN


Loan Number:




For and in consideration of the sum of (Enter Total Contract Amount) $ , and upon receipt thereof, ___________________________ ("Contractor") waives and releases any and all present or future liens that Contractor may have or may be able to obtain, under any applicable law pertaining to mechanic's and/or material liens, upon the following premises:


Property Address:


If the total amount to be paid to the Contractor will be subject to a schedule of payments to Contractor, then Contractor's waiver and release of liens will occur simultaneously with each payment and to the extent of such payment.


Contactor, declares that I am/It is:


(1) A Duly licensed, bonded and insured under all applicable laws and regulations, and will comply with all applicable codes and regulations concerning residential repair or reconstruction (including without limitation all building codes, zoning, permit, and inspection regulations);
(2) Qualified and experienced to perform the type of work contracted for, and financially able to complete the repair or reconstruction within scheduled timeframes;
(3) To repair damage at the property listed above as reported in the insurance adjuster's report unless specifically noted; and
(4) To waive all liens upon payment.


****Do not fill out the Bond information if you are submitting a copy of your license*****
Name of Surety Company Issuing Bond: _______________________________________
Surety Bond Number: _________________________
Amount of Surety Bond: $________________________________________________




 

Note: For faster delivery, UPLOAD form on our website or FAX to .