RUS Form 224 Waiver and Release of Lien

A ccording 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 OMB control 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 per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

U.S. Department of Agriculture

Rural Utilities Service

WAIVER AND RELEASE OF LIEN

WHEREAS the undersigned, ____________________________________________________________________
NAME OF MANUFACTURER, MATERIAL SUPPLIER, OR SUBCONTRACTOR

has furnished to __________________________________________________________________ the following:
NAME OF CONTRACTOR

_________________________________________________________________________________________ for
KIND OF MATERIAL AND SERVICES FURNISHED

use in the construction of a project belonging to _____________________________________________________
NAME OF BORROWER

and designated by the Rural Utilities Service as _____________________________________________________
RUS DESIGNATION

NOW, THEREFORE, the undersigned, _____________________________________________________________
NAME OF MANUFACTURER, MATERIAL SUPPLIER, OR SUBCONTRACTOR

for and in consideration of $________________________________________ and other good and valuable consideration, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all liens, or right to or claim of lien, on the above described project and premises, under any law, common or statutory, on account of labor or materials, or both, heretofore or hereafter furnished by the undersigned to or for the account of

said __________________________________________________________________________ for said project.
NAME OF CONTRACTOR

Given under my(our) hand(s) and seal(s) this __________________ day of ____________________, 20_______.

__________________________________________________

Name of Manufacturer, Material Supplier, or Subcontractor

By __________________________________________________

President

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 the Manufacturer, Material Supplier, or Subcontractor is a corporation, this Waiver and Release of Lien must be signed in the corporate name by a duly authorized officer and the corporate seal affixed and attested by the Secretary of the Corporation.

RUS FORM 224 (Rev. 11-01)