Fillable Discharge of construction Lien cLaim (Foundation Title)

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Discharge of construction Lien cLaim (Foundation Title)

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Discharge of construction Lien cLaim
TO THE RECORDING OFFICER, COUNTY OF ___________
1. The Claimant whose name is
______________________________________________________________________________
and whose address is
______________________________________________________________________________
filed a CONSTRUCTION LIEN CLAIM against the below stated real property (called the “Property”)
owned by ___________________________________________ for the value of work, services, materials
or equipment provided in accordance with a contract between the Claimant and
_______________________________________________.
2. The Property is described as Lot ___________, Block ____________on the Tax Map of the
___________, County of _________________, State of New Jersey.
3. The lien claim was filed on ___________ as No. ___________ in Book ___________ at Page
___________, or in Instrument No. ______________.
4. A Notice of Unpaid Balance and Right to File Lien (if any) was filed as No. ___________ in Book
___________ at Page ___________, or in Instrument No. _________________.
5. Amendments to the original claim were recorded in Book ___________ at Page ___________ or
Instrument No. ___________________.
6. DISCHARGE. I hereby request and authorize the CONSTRUCTION LIEN to be DISCHARGED.
Date: ___________
Signed:
______________________________________
Name/Title: ____________________
On Behalf of: ___________________________
Note: This form must be signed by the Claimant or the Attorney for the Claimant.
STATE OF ____________, COUNTY OF ____________
SS:
I CERTIFY that on ____________
_____________________________________________________________________________________
personally came before me and stated to my satisfaction that this person (or if more than one, each
person):
(a) was the maker of this instrument; and,
(b)executed this instrument as his or her own act.
________________________________
STATE OF ____________, COUNTY OF ____________
SS:
I CERTIFY that on ____________
_____________________________________________________________________________________
personally came before me and stated to my satisfaction that this person (or if more than one, each
person):
(a) was the maker of this instrument
(b) was authorized to and did execute this instrument as ______________ of ____________________ the
entity named in this instrument; and,
(c) executed this instrument as the act of the entity.
________________________________
RECORD AND RETURN TO:
____________________________________
(For Recorder’s Use Only)
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Discharge of construction Lien cLaim (Foundation Title)

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Completed 23 September 2021

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