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Sample Lien Waiver PDF

This sample lien waiver PDF shows the typical structure and fields found in many lien waivers — provided for reference only. It is not state-specific and not legal advice.

Before you download

  • Not state-specific
  • Not contract-specific
  • For reference only
  • May not be legally valid

What this sample shows

This sample lien waiver PDF is meant to help you understand the common fields and layout typically found in lien waivers, including:

  • Claimant (waiving party) information
  • Project name and location
  • Owner / GC / customer names
  • Waiver amount
  • Coverage period or through date
  • Signature and date

What this sample does NOT do

  • It does not account for state-specific statutory requirements
  • It does not replace contract-required language
  • It does not determine conditional vs unconditional correctly for you
  • It does not guarantee acceptance by a GC or portal

Important note

In states like California, generic lien waiver samples are often rejected outright. Always verify requirements before using any template.

Download the sample

Use this sample to familiarize yourself with lien waiver structure — then use a state-aware tool to generate the correct waiver for your project.

Need a waiver that actually fits your project?

LienWaiverPro is built to guide you through the right questions and generate lien waivers that match your billing stage and state expectations.

Disclaimer: This sample lien waiver is provided for general informational purposes only and does not constitute legal advice. Lien waiver requirements vary by state, contract, and project. Consult a qualified construction attorney for guidance specific to your situation.