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COMPANY NAME

WAIVER OF LIEN TO DATE

 

S STATE OF ILLINOIS

Gty #

COUNTY OF

Escrow #

TO WHOM IT MAY CONCERN:

 

WHEREAS the undersigned has been employed by

 

to furnish

 

for the premises known as

 

of which

is the owner.

THE undersigned, for and in consideration of

($) Dollars, and other good and valuable considerations, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all lien or claim of, or right to, lien, under the statutes of the State of Illinois, relating to mechanics’ liens, with respect to and on said above-described premises, and the improvements thereon, and on the material, fixtures, apparatus or machinery furnished, and on the moneys, funds or other considerations due or to become due from the owner, on account of all labor, services, material, fixtures, apparatus or machinery, furnished to this date by the undersigned for the above-described premises,

INCLUDING EXTRAS.* DATE

ADDRESS

SIGNATURE AND TITLE _______________________________________________________________________________

*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT

CONTRACTOR’S AFFIDAVIT

STATE OF ILLINOIS

COUNTY OF

 

TO WHOM IT MAY CONCERN:

 

THE UNDERSIGNED, (NAME)

BEING DULY SWORN, DEPOSES

AND SAYS THAT HE OR SHE IS (POSITION)

OF

(COMPANY NAME)

WHO IS THE

CONTRACTOR FURNISHING

WORK ON THE BUILDING

LOCATED AT

 

OWNED BY

 

That the total amount of the contract including extras* is $

on which he or she has received payment of

$prior to this payment. That all waivers are true, correct and genuine and delivered unconditionally and that there is no claim either legal or equitable to defeat the validity of said waivers. That the following are the names and addresses of all parties who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work or for material entering into the construction thereof and the amount due or to become due to each, and that the items mentioned include all labor and material required to complete said work according to plans and specifications:

NAMES AND ADDRESSES

WHAT FOR

CONTRACT PRICE INCLDG EXTRAS*

AMOUNT

PAID

THIS

PAYMENT

BALANCE

DUE

TOTAL LABOR AND MATERIAL INCLUDING EXTRAS* TO COMPLETE.

That there are no other contracts for said work outstanding, and that there is nothing due or to become due to any person for material, labor or other work of any kind done or to be done upon or in connection with said work other than above stated.

DATE_______________________________

SIGNATURE:_______________________________________________

SUBSCRIBED AND SWORN TO BEFORE ME THIS______________________DAY OF__________________,__________

*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE

 

_____________________________________________

ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT.

NOTARY PUBLIC

f.1722 R5/96

Provided by Chicago Title Insurance Company

Document Information

Fact Name Description
Form Purpose This form is used to waive any lien rights under Illinois mechanics' lien laws.
Governing Law The form is governed by the mechanics' lien statutes of the State of Illinois.
Parties Involved The form involves the contractor, the owner of the property, and the company providing the waiver.
Consideration The undersigned waives their lien rights in exchange for a specified dollar amount.
Extras Definition Extras include change orders, both oral and written, related to the contract.
Affidavit Requirement An affidavit must be completed by the contractor confirming the waiver's validity.
Payment Details The form requires disclosure of total contract amounts and payments received.
Signature Requirement The form must be signed by the contractor and notarized to be valid.
Submission The completed form should be submitted to relevant parties involved in the contract.
Notary Public A notary public must witness the signature to ensure authenticity.

Chicago Title Waiver Format - Usage Guidelines

Filling out the Chicago Title Waiver Format form requires attention to detail. This document is essential for ensuring that all parties involved in a construction project are clear about payments and claims related to mechanics’ liens. Here’s how to complete the form step by step.

  1. Company Name: Write the name of the company that is waiving the lien at the top of the form.
  2. Waiver of Lien to Date: Fill in the date for which the waiver is effective.
  3. State and County: Indicate the state (Illinois) and the county where the property is located.
  4. Escrow Number: Enter the relevant escrow number associated with the transaction.
  5. To Whom It May Concern: Leave this section as is, as it is standard wording.
  6. Undersigned: Write the name of the person or entity that has been employed to furnish work.
  7. Premises Known As: Provide the address or description of the property involved.
  8. Owner: State the name of the property owner.
  9. Consideration Amount: Fill in the dollar amount that is being acknowledged as received.
  10. Date: Enter the date when the waiver is being signed.
  11. Address: Write the address of the undersigned party.
  12. Signature and Title: The undersigned should sign and print their title below the signature.
  13. Contractor’s Affidavit Section: Complete this section with the contractor’s name, position, and company name.
  14. Building Location: Specify the address of the building where the work is being done.
  15. Total Contract Amount: Fill in the total contract amount, including any extras.
  16. Payment Received: Indicate the amount that has been paid prior to this payment.
  17. Names and Addresses: List all parties who have furnished labor or materials, including their addresses.
  18. Contract Price: Specify the contract price for each party listed, including extras.
  19. Amount Paid: Fill in the amount paid for this payment for each listed party.
  20. Balance Due: Indicate the remaining balance due for each party.
  21. Date: Write the date when the affidavit is being signed.
  22. Signature: The contractor should sign the affidavit.
  23. Notary Section: Leave space for the notary public to sign and date the document.

After completing the form, ensure that all information is accurate and legible. The next steps involve having the document notarized and distributing copies to relevant parties. This will help maintain clarity and protect the rights of everyone involved in the construction project.

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Dos and Don'ts

When filling out the Chicago Title Waiver Format form, it's important to follow certain guidelines to ensure accuracy and compliance. Here are six things you should and shouldn't do:

  • Do provide the complete company name at the top of the form.
  • Do clearly state the amount being waived in the appropriate section.
  • Do include the correct property address to avoid confusion.
  • Do ensure all signatures are present and legible.
  • Don't leave any sections blank; fill out all required fields.
  • Don't forget to have the form notarized where indicated.

Common mistakes

  1. Incorrect Company Name: Ensure the company name is filled out accurately. A misspelled or incomplete name can lead to issues with the waiver's validity.

  2. Missing Property Address: Clearly state the address of the property involved. Omitting this detail can create confusion about which premises the waiver pertains to.

  3. Inaccurate Payment Amount: Double-check the dollar amount being waived. An incorrect figure can lead to disputes later on regarding what was actually waived.

  4. Neglecting to Include Extras: Remember to mention any extras, such as change orders. Failing to include these can affect the completeness of the waiver.

  5. Signature Issues: The form must be signed by the correct person. Ensure that the individual signing has the authority to do so, and that their title is included.

  6. Notary Section Left Blank: The notary public section is crucial. Make sure it is filled out properly to validate the document.

  7. Omitting Contractor's Affidavit: If applicable, include the contractor’s affidavit. This is essential for confirming the legitimacy of the waiver.

  8. Failure to Provide Complete Payment History: List all parties involved and their payment status. Incomplete information can lead to complications or claims later on.

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