(Top 3 inches reserved for recording data) ASSIGNMENT OF MECHANIC'S LIEN by Individual(s) DATE: Minnesota Uniform Conveyancing Blanks Form 40.2.1 (2011) (month/day/year) FOR VALUABLE CONSIDERATION, hereby sells, assigns, and transfers to a mechanic's lien, the verified statement and claim for which is dated (insert name of each Assignor) , ("Assignor"), , ("Assignee"), , executed by , (or in Book (insert name of each Assignee) (month/day/year) and recorded on of Page (month/day/year) , as Document Number ), in the Office of the (insert name of party signing original lien statement) County Recorder Registrar of Titles of (check the applicable boxes) County, Minnesota, together with all right and interest in and to the debt thereby secured. Assignor (signature) (signature) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Minnesota Uniform Conveyancing Blanks Form 40.2.1 State of Minnesota, County of This instrument was acknowledged before me on , by . (month/day/year) (insert name of each Assignor) (Stamp) (signature of notarial officer) Title (and Rank): My commission expires: (month/day/year) THIS INSTRUMENT WAS DRAFTED BY: (insert name and address) American LegalNet, Inc. www.FormsWorkFlow.com