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Final Waiver of Lien <br />State of Indiana, County of SS: <br />5 being duly swornthat he/she is the <br />(Name <br />of" cer) <br />(Title) <br />of <br />having Contracted with <br />-Ae �(Contractor)� <br />(Owner) <br />to furnish certain materials and/or labor as follows; . ..... . <br />(Description) <br />for a project known as <br />located at <br />and owned by <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />Dollars <br />El receipt Of which is hereby a6l"Mledged; or <br />❑ 1110 PaYmcnt otwh1uh has been promised as the Role consideration for this Affidavit and Filial Waiver OfLiell which is given <br />Solely With respect to said amount, and which Waiver shall be effective oni <br />undersigned, Y Upon receipt Of payment thereof by tile <br />JFINAL WAIV R) that the final balance clue from the contr4at r is the P sum of <br />ev <br />❑receipt of which is hereby acknowledged; or �v <br />,the <br />paynient of which has been promised as the sole coasideration for this Affidavit and Final Waiver of Lien which shall <br />ecome effective only upon receipt of such parnont. <br />THEREFORE, time Undersigned waives and releases unto the Owner ofsald premises, ally and all liens or claims Whatsoever <br />oil 410 above -described Property and improvements thcteOu an account oflabor or material or both, furnished b the undersigned <br />thereto, sUbicot to 11i'llitations Or conditions expressed herein, if say; avid further certified that no other party has tiny claim or right to a <br />)ICA On account ofany work performed or material Airuished to the undersigned for stildproject, and whhIn the Scope of this Afridavft <br />arid Waiver ofUen. <br />MOLLY"SHE <br />,a ( Uthol <br />-Mate <br />of Indiana <br />783 Sta Po 5 Jan 9, 2027 <br />(Firni) Notary PUbl <br />STATE OF MDIANA St Joseph County - St e of India I ( uthor <br />Commission Number NP0717835 <br />My Commission Expires Jan 9, 2027 <br />ST, JOSEPH COUNI'Y <br />13601`0 me, the undersigned, a Notary Public, In and for said Countyand State, Personally appeared <br />and aolgiowledged the execution of the foregoing Affidavit and Waiver of Lion. <br />IN wrr Niss W'HEREOF, I have h0r0untOSUbscribed my name and affixed my offic"IrW: <br />200 <br />My Commission Expires., --�A N1 4o—A --- <br />Residing in &Aokpa— County, -JNQjNk___ <br />� h <br />)'. ILK LaE M W) <br />/A Cl-b- day of <br />-t61+1:---P,MAN <br />