CERTIFICATION OF SATISFACTION OF LIEN

Whereas, on [date] , [lienholder] 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 , against
property owned by [owner] , of [address] , for
[description of work performed] by [name of lienholder],
the description of which is as follows:

Whereas, on [date] , [owner] fully satisfied the
indebtedness secured by said mechanic’s lien.

Therefore, in consideration of said payment, [lienholder]
hereby certifies that said lien is released and discharged,
and directs the County [name of office] to discharge of
record said lien.

Dated:______________________ _________________________
[Signature]
[Acknowledgment]