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1. Project Identification: Details of the construction project including address and contract reference
2. Payment Information: Amount received, payment period covered, and payment date
3. Scope of Waiver: Specific rights being waived and work covered by the waiver
4. Waiver Declaration: Formal statement of waiver of lien rights
5. Signing Block: Execution section including date and authorized signatures
1. Retained Rights: Statement of rights specifically reserved or not waived, used when certain claims are being preserved
2. Conditional Language: Conditions precedent to waiver effectiveness, used when waiver depends on specific events
3. Subcontractor Acknowledgments: Confirmation of payments to subcontractors, used in complex projects with multiple tiers
1. Payment Schedule: Detailed breakdown of payments received and covered by the waiver
2. Work Description Schedule: Detailed description of work completed and covered by the waiver
3. Outstanding Claims Schedule: List of any preserved or outstanding claims not covered by the waiver
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