PARTIAL SATISFACTION OF LIEN

STATE OF

COUNTY OF

WHEREAS, the undersigned,	, as for	, a	corporation, having filed a Claim of Lien against the property of	on the day of	,	, in Official Records Book at Page , in the office of the Clerk of the Circuit Court of	County, State of Florida, against the real property in said county, described as:

in the amount of $ .

NOW, THEREFORE, the undersigned, for Ten Dollars ($10.00) and other good and valuable consideration does hereby partially release $ of the subject Claim of Lien, and does direct the Clerk of the Circuit Court to cancel and discharge the Claim of Lien to the extent of said $ in accordance with Sections 713.21 and 713.24 of the Florida Statutes. The Claim of Lien is not released and remains in tact as to the remaining principal balance of $ .

Signed, sealed and delivered this ______ day of ,	.

By:

Title:

STATE OF

COUNTY OF

The foregoing instrument was acknowledged before me this day of ,	, by (name), as (title) of (name of corporation), a (State) corporation, on behalf of the corporation. He/She [please check as applicable] /______/ is personally known to me, or has produced /______/ his/her (state) driver's license, or /______/ his/her (type of identification) as identification.

(Signature)

(Printed Name)

NOTARY PUBLIC, STATE OF

(Commission Expiration Date)