WHEREAS, on [date], [lien holder] caused a lien to be
filed for record in the office of [name of office], of
County, State of, which was duly recorded in Volume
[#], page [#], of [paragraph], against property owned
by [owner], of [address], for work performed
[description] by [name of lien holder], the description
of which is as follows:
[description]
WHEREAS, on [date], [owner] fully satisfied the indebtedness
secured by said mechanic's lien. Therefore, in consideration
of said payment, [lien holder] hereby certifies that said lien is
released and discharged, and directs the County [name of
office] to discharge of record said lien.
Dated:
________________________________________
Lien holder (clearly print name after signature)
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