Transcription of Waiver and Relase of Lien - USDA Rural Development
1 According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMBcontrol number. The valid OMB control number for this information collection is 0572-0107. The time required to complete this information collection is estimated to average 1 minute perresponse, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of Department of AgricultureRural Utilities ServiceWAIVER AND release OF LIENWHEREAS the undersigned,NAME OF MANUFACTURER, MATERIAL SUPPLIER OR SUBCONTRACTORhas furnished tothe following:NAME OF CONTRACTORforKIND OF MATERIAL AND SERVICES FURNISHEDuse in the construction of a project belonging toNAME OF BORROWERand designated the Rural Utilities Service asRUS DESIGNATIONNOW, THEREFORE, the undersigned,NAME OF MANUFACTURER, MATERIAL SUPPLIER, OR SUBCONTRACTORfor and in consideration of $ and other good and valuableconsideration, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all liens, orright to or claim of lien, on the above described project and premises, under any law, common or statutory, onaccount of labor or materials, or both, heretofore or hereafter furnished by the undersigned to or for the account offor said projectsaidNAME OF CONTRACTORday of,20 Given under my (our) hand(s) and seal(s)
2 ThisName of Manufacturer, Material Supplier, or SubcontractorByPresidentRUS FORM 224 (Rev. 2-04).This Waiver and release of Lien must be signed with the full name of the Manufacturer, Material Supplier, or Subcontractor. If the Manufacturer,Material Supplier, or Subcontractor is a partnership, this Waiver and release of Lien must be signed in the partnership name by a partner. If theManufacturer, Material Supplier, or Subcontractor is a corporation, this Waiver and release of Lien must be signed in the corporate name by aduly authorized officer and the corporate seal affixed and attested by the Secretary of the (exp. date 5/31/21)
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