Satisfy a Lien

Satisfaction of Lien

1 - Our Company Name *

2 - Authorized By *

3 - Phone Number *

4 - Email Address *

5 - Address Liened (Jobsite address) *

6 - Client Who Hired You

7 - Lien # (if known)

I/We agree to pay Speedy Lien, Inc. $300.00 (or $400.00 for Liens filed in Nassau County). *

Yes

Date

**Additional fees may apply if the Lien was not initially filed by Speedy Lien.**

Paying by Credit or Debit Card, Complete the Following:

Use Credit Card on File

Yes

Cardholder's Name

Billing Address

Zip Code

Card Number

Exp Month

Exp Year

I/We authorize Speedy Lien, Inc. to charge my/our credit card. *

Yes

Check Payable to: Speedy Lien, Inc. Print Satisfaction Request, Prepare Check and Email DN@SpeedyLienInc.com

Or Fax: 516-679-6703