Prepared By: ________________________ ________________________ ________________________ CANCELLATION OF LIEN Know All Men My These Presents: That _______________________________________________________, the same being the executor of a certain Claim of Lien against _____________________________________ recorded on the ____Day of ___________________________, 20___ in Official Records Book ______________ Page ________________ of the public records of Leon County, Florida for the principal sum of $____________________ and against the property of the said _________________________________ more particularly described as follows, to wit: Hereby acknowledge full payment and satisfaction of said lien and surrender the same as cancelled. Signed, Sealed and Delivered in the presence of: __________________________ Witness Signature __________________________ Printed Name __________________________ Witness Signature __________________________ Printed Name _______________________________ Signature ________________________________ Printed Name STATE OF FLORIDA COUNTY OF LEON The foregoing instrument was acknowledged before me this ______ day of ____________________, 20____, by ______________________________, who is personally known to me or has produced ____________________ as identification and who did/did not take an oath. Gwen Marshall, Leon Co. Clerk of the Circuit Court & Comptroller _____________________________________ Signature of Notary/Deputy Clerk _____________________________________ Printed Name American LegalNet, Inc. www.FormsWorkFlow.com