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Final Waiver of Lien <br />State of Indiana, County of �U''SS: <br />C <br />zz_ being duly sworn that he/she is the ' �✓% <br />(N (Title) <br />of -fG/'.) , ✓ ', having contracted with Cy_ � l� <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows; <br />for a project known as <br />located at <br />i <br />(Name of <br />tf <br />and owned by <br />(Owner) « � <br />I I N UA J I L 0 Y <br />w,,..„ . <br />and does hereby Further state on the behalf oFthe aforementioned sttbcontraotot/supplie o, � Notary Pw�ttt;e, State of dwwtttsrwar <br />s"Sltl ro St, Joseph County <br />emmisstcn Number NP0721620 <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of °,'�'wnr ��`` My t Nrnlastcn Expires <br />d" 4Parutrrw" <br />Dollars <br />(;{ receipt of which is hereby aclatowledged; or <br />❑ the payment of which has been promised as the sole consideration for this Affidavit attd Final Waiver of Lien which is given <br />solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the <br />undersigned; <br />l INAL WAIVER that the final � the sum of <br />(« balance due from the contractor <br />Xreceipt of which is hereby acknowledged; or <br />❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall <br />become effective only upon receipt of such payment. <br />THEREFORE, the undersigned waives and releases unto the Owner ofsaid t noses; any and all liens or claims whatsoever <br />on the above -described property and improvements thereon an account of labor atonal both„ furnished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and fttrth certificd th ;no other party has any claim or right to a <br />Ran on account of any work performed or material famished to the undersign for said pr ect, and within the scope of this Affidavit <br />and Waiver of Lien. <br />� <br />(Firm) thorned It <br />G ' B � topres e) <br />STATE OF INDIANA <br />SS: <br />ST. JOSEPH COUNTY } <br />Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared <br />and acknowledged the execution oftho foregoing Affidavit and Waiver of Liou« <br />IN WITNESS MIJ REOF, I have horonnto subscrlb name affixed my official seal' -n the ,�Z day of <br />tll <br />m,�_"' <br />Notary Publi gnatemv <br />My Commission Expires: 7 — —a� <br />Reslding in County, ,+ Notary Public Name <br />