(Consult an attorney before using this form or relying on this information)
CONDITIONAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT
The undersigned lienor, in consideration of the sum of $_____ [insert actual amount to be paid, not $10] to be paid and expressly subject thereto will waive and release its lien and right to claim a lien for labor, services, or materials furnished through (insert date) to (insert the name of your customer) on the job of (insert the name of the owner) to the following property:
(description of property)
This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified. Further, this waiver and release is expressly conditioned upon the undersigned’s actual receipt of the above referenced amount in paid/cleared funds. Otherwise, this waiver and release is void.
DATED on _____, (year) .