Waiver Type

Claimant (You)

Company / Business Name

Signatory Name

Title / Position

Property & Owner

Property Owner Name

Customer / GC Name (if different)

Property Address

Job Description

Payment Details

Progress Payment Amount

Payor Name (who is paying)

Check / Wire / ACH Number

Work Completed Through Date

Signature Date

Digital Signature

By checking this box and typing my name above, I am signing this lien waiver electronically and agree it has the same legal effect as a handwritten signature.

⚠️ Conditional Waiver — Progress Payment — Waives lien rights upon receipt of a progress payment. Most common type.

Conditional Waiver and Release of Lien

Upon Progress Payment

The undersigned has been hired by _______________ to furnish certain labor, services, equipment, and/or materials for the improvement of the property located at _______________ (the "Property"), generally described as: construction services.

Upon receipt by the undersigned of a check from _______________ in the sum of ____________, payable to _______________, and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's lien, stop payment notice, or bond right the undersigned has on the above-referenced Property for labor, services, equipment, or materials furnished through April 19, 2026.

This release covers a progress payment for the work, materials, or equipment furnished by the undersigned to _______________ and does not cover any retention or items, changes or extras for which the undersigned has not received payment.

NOTICE: This document waives rights unconditionally and states that you have been paid for giving up those rights. This document is enforceable against you if you sign it, even if you have not been paid. If you have not been paid, use a conditional release form.

Signature

Signature of Claimant

_______________

Printed Name

April 19, 2026

Date

NOTICE: This document is effective only upon receipt and clearance of payment in the amount stated above. If the check described above is dishonored, this waiver is void and of no effect.

⚖️ Lien waiver laws vary by state. This generator provides a standard template — consult a construction attorney for state-specific requirements.