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Preview - Chicago Title Waiver Format Form

COMPANY NAME

WAIVER OF LIEN TO DATE

 

S STATE OF ILLINOIS

Gty #

COUNTY OF

Escrow #

TO WHOM IT MAY CONCERN:

 

WHEREAS the undersigned has been employed by

 

to furnish

 

for the premises known as

 

of which

is the owner.

THE undersigned, for and in consideration of

($) Dollars, and other good and valuable considerations, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all lien or claim of, or right to, lien, under the statutes of the State of Illinois, relating to mechanics’ liens, with respect to and on said above-described premises, and the improvements thereon, and on the material, fixtures, apparatus or machinery furnished, and on the moneys, funds or other considerations due or to become due from the owner, on account of all labor, services, material, fixtures, apparatus or machinery, furnished to this date by the undersigned for the above-described premises,

INCLUDING EXTRAS.* DATE

ADDRESS

SIGNATURE AND TITLE _______________________________________________________________________________

*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT

CONTRACTOR’S AFFIDAVIT

STATE OF ILLINOIS

COUNTY OF

 

TO WHOM IT MAY CONCERN:

 

THE UNDERSIGNED, (NAME)

BEING DULY SWORN, DEPOSES

AND SAYS THAT HE OR SHE IS (POSITION)

OF

(COMPANY NAME)

WHO IS THE

CONTRACTOR FURNISHING

WORK ON THE BUILDING

LOCATED AT

 

OWNED BY

 

That the total amount of the contract including extras* is $

on which he or she has received payment of

$prior to this payment. That all waivers are true, correct and genuine and delivered unconditionally and that there is no claim either legal or equitable to defeat the validity of said waivers. That the following are the names and addresses of all parties who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work or for material entering into the construction thereof and the amount due or to become due to each, and that the items mentioned include all labor and material required to complete said work according to plans and specifications:

NAMES AND ADDRESSES

WHAT FOR

CONTRACT PRICE INCLDG EXTRAS*

AMOUNT

PAID

THIS

PAYMENT

BALANCE

DUE

TOTAL LABOR AND MATERIAL INCLUDING EXTRAS* TO COMPLETE.

That there are no other contracts for said work outstanding, and that there is nothing due or to become due to any person for material, labor or other work of any kind done or to be done upon or in connection with said work other than above stated.

DATE_______________________________

SIGNATURE:_______________________________________________

SUBSCRIBED AND SWORN TO BEFORE ME THIS______________________DAY OF__________________,__________

*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE

 

_____________________________________________

ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT.

NOTARY PUBLIC

f.1722 R5/96

Provided by Chicago Title Insurance Company
⇓ Chicago Title Waiver Format PDF

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Similar forms

  • Mechanics' Lien Waiver: This document serves a similar purpose as the Chicago Title Waiver Format form. It allows contractors and subcontractors to waive their right to file a mechanics' lien against a property. Both documents ensure that the property owner is protected from future claims related to unpaid services or materials.
  • Release of Lien: A release of lien is often used when a contractor or supplier has been paid for their work. Like the Chicago Title Waiver, it releases any claims against the property for the specified work, providing assurance to the property owner that no further claims will arise from that project.
  • Motor Vehicle Bill of Sale: This form is crucial for documenting the sale of a motor vehicle, ensuring proper ownership transfer. For more detailed information on how to fill out the form, visit pdftemplates.info/texas-motor-vehicle-bill-of-sale-form/.
  • Contractor's Affidavit: This document is typically used to affirm that all parties involved in a construction project have been paid. It complements the Chicago Title Waiver by confirming that the contractor has settled all accounts, thus protecting the owner from future claims.
  • Final Payment Release: Similar to the Chicago Title Waiver, this document is signed at the end of a project. It indicates that the contractor has received full payment and waives any rights to claim against the property for the work completed.
  • Subcontractor Waiver: This document is specifically for subcontractors and serves to waive their rights to file a lien. It aligns with the Chicago Title Waiver Format by ensuring that all parties involved in the project agree to release any claims related to unpaid work or materials.