Free Lien Waiver Form for Contractors (Printable Template)
Below is a simple conditional waiver and release on progress payment you can print and use where your state does not require a specific form. Fill it in on screen, then print it or save it as a PDF.
Check your state first. Several states require a statutory lien waiver form with exact wording, and a waiver in any other format may not be valid. These include Arizona, California, Florida, Georgia, Massachusetts, Michigan, Mississippi, Missouri, Nevada, Texas, Utah and Wyoming. Use your state's form there, and ask your attorney if you are unsure.
Conditional Waiver and Release on Progress Payment
Project name and address:
Property owner:
Claimant (subcontractor or supplier):
Customer (who hired the claimant):
Payment amount: $
Work and materials through (date):
Upon receipt by the claimant of payment in the amount above, and once that payment has cleared the bank, the claimant waives and releases any mechanics lien, stop notice and payment bond rights it has for labor, services, equipment and materials furnished to the project through the date above. This waiver does not cover retention, extras or disputed claims not included in the payment amount, or work performed after that date. If payment is not received or does not clear, this waiver has no effect.
Claimant signature:
Name and title:
Date:
How to use this lien waiver form
- The sub fills it in for the amount on their pay application and sends it with the invoice.
- You release the payment.
- Once the payment clears, collect an unconditional waiver for that same amount, usually with the next pay application.
- For the last payment, use a final waiver instead, conditional first and unconditional once paid.
Read conditional vs. unconditional lien waivers for when to use each type.
Does a lien waiver need to be notarized?
In most states, no. A few states, such as Texas for some waivers, have required notarization in the past, and rules change, so check your state. Notarizing is never harmful, just slower.
This form is a general template, not legal advice. Lien laws vary by state.