Lien holder name
Dear Mr./Mrs. XYZ,
While, on (date….), (lien holder name/company) caused a lien being filed for record at company of (name of office) connected with County, city of, that has been duly recorded in Amount, page, of, against property owned by (owner name…), of (address…), for (description with work performed….) by (name of lien holder), the description of which is as follows:
While, on (specific date…), (owner name….) thoroughly satisfied the indebtedness attached by said mechanic’s lien.
Therefore, in consideration of said payment, (lien holder) hereby certifies that said lien is released and discharged, and directs the Company (name of office) to discharge of record said lien.