← Mississippi lien waivers
MSSTATUTORY FORMNOTARIZATION REQUIRED

Conditional Lien Waiver — Progress Payment

Mississippi · Mississippi Code § 85-7-433

When to Use This Form
When to sign
Submit with progress payment application. Must be notarized.
Who signs
Contractor, subcontractor, or materialman — must sign before a notary
Free Mississippi Template
Copy and fill in the blanks
CONDITIONAL LIEN WAIVER — PROGRESS PAYMENT
(Mississippi Code § 85-7-433)

State of Mississippi
County of _________________

Claimant: _________________
Project: _________________
Owner: _________________
Through Date: _________________

Upon receipt of $_________, claimant waives all lien and claim rights for labor, materials, or services furnished through the through date. This waiver is conditioned on receipt of payment.

Signature: _________________
Title: _________________

Subscribed and sworn before me this ___ day of _________, 20__

Notary Public: _________________
My commission expires: _________________

Fill in all blank fields before signing. In Mississippi, using a non-statutory form may void the waiver. This form must be notarized.

⬇ Generate Filled PDF — First one free
Common Questions
Yes. Mississippi Code § 85-7-433 requires lien waivers to be acknowledged before a notary public. A lien waiver without notarization is not valid in Mississippi.
Other Mississippi Lien Waiver Forms
Unconditional Lien Waiver — Progress Payment
Sign after payment clears. Must be notarized.
Conditional Final Lien Waiver
Submit with final payment application. Must be notarized.
Unconditional Final Lien Waiver
Sign only after all final payment has cleared. Must be notarized.
Legal disclaimer: The forms on this site are provided for general informational purposes only and do not constitute legal advice. Construction lien laws are complex and vary by project type and circumstances. Always consult a licensed construction attorney before relying on any lien waiver for a real project.