Simple Pay Application

Georgia lien waiver forms and what the statute says

Georgia sets two lien waiver forms in O.C.G.A. 44-14-366: an interim form in subsection (d) and a final form in subsection (e), with a third form, the affidavit of nonpayment, in subsection (g)(2)(C). The waivers are not conditional and unconditional pairs; each is signed on the receipt of a sum and takes effect on the conditions the statute sets out.

A project located in Georgia gets all three forms in the app with the statute's wording unchanged. The amount, the through date and the names are filled from the pay app the payment is for; you sign, and the waiver goes into the same PDF as the pay application.

Sample Georgia lien waiver on the statutory form
A filled sample of Georgia's interim waiver, O.C.G.A. 44-14-366(d), printed by the app.

The three Georgia forms at a glance

The interim form goes with any payment other than the final one, so it sits where other States put their progress waivers. The final form goes with the final payment. The right-hand column quotes the statute's own words on when each is used.

FormSectionKind pagesWhen it is used, in the statute's words
Waiver and Release of Lien and Payment Bond Rights upon Interim Payment44-14-366(d)Conditional, progress and unconditional, progress“When a claimant is requested to execute a waiver and release in exchange for or in order to induce payment other than final payment”
Waiver and Release of Lien and Payment Bond Rights upon Final Payment44-14-366(e)Conditional, final and unconditional, final“in exchange for or in order to induce making of final payment”
Affidavit of Nonpayment44-14-366(g)(2)(C)Not a waiver, so no kind page“THE UNDERSIGNED HEREBY GIVES NOTICE OF SUCH NONPAYMENT”

The statute prints no title line above the interim form. The title the app uses for it is the one subsection (d) gives it in its own text. Both waiver forms open with the State and county, name the contractor, the work, the project, its city and county and its owner, and then describe the property.

What O.C.G.A. 44-14-366 says about using them

Subsection (a) covers waivers of liens and of labor or material bond rights, and subsection (f) lists matters the section does not affect: subordinations, waivers made in settling a dispute, cancellations of recorded liens, and certain other Code sections. Subsection (c) is the rule that gives the forms their weight: No oral or written statement by the claimant purporting to waive, release, impair, or otherwise adversely affect a lien or bond claim is enforceable or creates an estoppel or impairment of claim of lien or claim upon a bond unless it is made on the prescribed waiver and release form, duly executed, and the claimant has received payment as subsection (g) sets out.

Subsections (d) and (e) say the waiver shall substantially follow the language of the following form. On type size the statute's words are be in at least 12 point font, and need not be in boldface capital letters, and the same line appears for the affidavit in (g)(2)(C). A mistake in a blank has its own rule: the failure to correctly complete any of the blank spaces in the above form shall not invalidate said form so long as the subject matter of said release may reasonably be determined.

Statute
O.C.G.A. § 44-14-366
Use of the form
Yes: a waiver is enforceable only on a form that substantially follows the statute’s language, and only once payment is made as the statute sets out (44-14-366(c), (d), (e)).
Who it applies to
Waivers of lien and of labor or material bond rights (44-14-366(a)). Subsection (f) lists matters the section does not affect.
Notary
The waiver forms have witness and address lines; the affidavit of nonpayment has a notary line.
Note
Under 44-14-366(g)(2) a waiver takes effect at the earliest of: receipt of the amount it states; a separate written acknowledgment of payment in full; or 90 days after it is signed, unless an affidavit of nonpayment is filed before then in the county where the property is located. The affidavit form is offered here.

Source: O.C.G.A. § 44-14-366. As published by Justia, 2025 edition, read Nov 12, 2026.

When a Georgia waiver takes effect

Under subsection (g)(2), a waiver takes effect at the earliest of three things: the claimant receives the amount the waiver states; the claimant gives a separate written acknowledgment of payment in full; or 90 days pass after the waiver is signed. The third can be stopped. If an affidavit of nonpayment is filed before the 90 days end, in the county where the property is located, the waiver does not take effect by the passing of time.

Each waiver form carries a notice that says the same thing to the signer. It says that on executing and submitting the document the signer is conclusively deemed to have waived and released the liens and bond rights, to the extent set out above, even without payment, 90 days after the date stated above, UNLESS YOU FILE AN AFFIDAVIT OF NONPAYMENT PRIOR TO THE EXPIRATION OF SUCH 90 DAY PERIOD. The notice ends by saying that leaving this notice language off the form makes the form unenforceable as a waiver and release under the section. The app prints the notice on both Georgia waivers; the sample shows it in bold capitals below the witness and address lines.

The affidavit of nonpayment

The affidavit is the form a claimant files when a waiver has been signed and the money has not arrived. It names the contractor, the work and the project, in the same opening as the waivers, then states that the claimant executed a waiver dated on a given day, gives the amount set out in that waiver, says it has not been paid in full, and gives the amount that remains unpaid. The undersigned swears those facts, signs on a seal line, and the form has lines for a witness and a notary public.

The form ends with a paragraph on copies. Within seven days of filing, the filing party sends a copy by registered or certified mail or statutory overnight delivery to the owner of the property. If the filing party has no contract with the owner and a notice of commencement is on file for the improvement, a copy goes to the contractor at the address on the notice. Where the owner is an entity on file with the Secretary of State's Corporations Division, sending the copy to its address, or to its registered agent's address, on file is deemed sufficient. The app offers this form beside the two waivers.

What the interim and final forms release

Both waivers say that on the receipt of a sum, the mechanic or materialman waives and releases all liens or claims of liens on the described property, and any rights against a labor or material bond. The interim form limits that to the period through a date, and excepts the rights and liens the mechanic or materialman might have in any retained amounts. The final form has no through date and no exception for retained amounts.

Both forms close with the phrase given under hand and seal on a stated day, a line marked seal for the claimant's signature, and lines for a witness and the witness's address. The facts above say the waivers carry witness and address lines and that the affidavit carries a notary line.

The full text of each form

Below is each Georgia form as the app prints it, word for word. The blanks and the capitalized prompts in brackets are the statute's own, and the app writes the job's details into them.

Waiver and Release of Lien and Payment Bond Rights upon Interim Payment O.C.G.A. § 44-14-366 (d), read Nov 12, 2026

STATE OF GEORGIA

COUNTY OF ____

THE UNDERSIGNED MECHANIC AND/OR MATERIALMAN HAS BEEN EMPLOYED BY ____ (NAME OF CONTRACTOR) TO FURNISH ____ (DESCRIBE MATERIALS AND/OR LABOR) FOR THE CONSTRUCTION OF IMPROVEMENTS KNOWN AS ____ (TITLE OF THE PROJECT OR BUILDING) WHICH IS LOCATED IN THE CITY OF ____, COUNTY OF ____, AND IS OWNED BY ____ (NAME OF OWNER) AND MORE PARTICULARLY DESCRIBED AS FOLLOWS:

____

____

____

(DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT NUMBER, OR STREET ADDRESS OF THE PROJECT.)

UPON THE RECEIPT OF THE SUM OF $____, THE MECHANIC AND/OR MATERIALMAN WAIVES AND RELEASES ANY AND ALL LIENS OR CLAIMS OF LIENS IT HAS UPON THE FOREGOING DESCRIBED PROPERTY OR ANY RIGHTS AGAINST ANY LABOR AND/OR MATERIAL BOND THROUGH THE DATE OF ____ (DATE) AND EXCEPTING THOSE RIGHTS AND LIENS THAT THE MECHANIC AND/OR MATERIALMAN MIGHT HAVE IN ANY RETAINED AMOUNTS, ON ACCOUNT OF LABOR OR MATERIALS, OR BOTH, FURNISHED BY THE UNDERSIGNED TO OR ON ACCOUNT OF SAID CONTRACTOR FOR SAID BUILDING OR PREMISES. GIVEN UNDER HAND AND SEAL THIS ____ DAY OF ____, ____.

____ (SEAL)

____

____

(WITNESS)

____

(ADDRESS)

NOTICE: WHEN YOU EXECUTE AND SUBMIT THIS DOCUMENT, YOU SHALL BE CONCLUSIVELY DEEMED TO HAVE WAIVED AND RELEASED ANY AND ALL LIENS AND CLAIMS OF LIENS UPON THE FOREGOING DESCRIBED PROPERTY AND ANY RIGHTS REGARDING ANY LABOR OR MATERIAL BOND REGARDING THE SAID PROPERTY TO THE EXTENT (AND ONLY TO THE EXTENT) SET FORTH ABOVE, EVEN IF YOU HAVE NOT ACTUALLY RECEIVED SUCH PAYMENT, 90 DAYS AFTER THE DATE STATED ABOVE UNLESS YOU FILE AN AFFIDAVIT OF NONPAYMENT PRIOR TO THE EXPIRATION OF SUCH 90 DAY PERIOD. THE FAILURE TO INCLUDE THIS NOTICE LANGUAGE ON THE FORM SHALL RENDER THE FORM UNENFORCEABLE AND INVALID AS A WAIVER AND RELEASE UNDER O. C. G. A. § 44-14-366.

Waiver and Release of Lien and Payment Bond Rights upon Final Payment O.C.G.A. § 44-14-366 (e), read Nov 12, 2026

STATE OF GEORGIA

COUNTY OF ____

THE UNDERSIGNED MECHANIC AND/OR MATERIALMAN HAS BEEN EMPLOYED BY ____ (NAME OF CONTRACTOR) TO FURNISH ____ (DESCRIBE MATERIALS AND/OR LABOR) FOR THE CONSTRUCTION OF IMPROVEMENTS KNOWN AS ____ (TITLE OF THE PROJECT OR BUILDING) WHICH IS LOCATED IN THE CITY OF ____, COUNTY OF ____, AND IS OWNED BY ____ (NAME OF OWNER) AND MORE PARTICULARLY DESCRIBED AS FOLLOWS:

____

____

____

(DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT NUMBER, OR STREET ADDRESS OF THE PROJECT.)

UPON THE RECEIPT OF THE SUM OF $ ____, THE MECHANIC AND/OR MATERIALMAN WAIVES AND RELEASES ANY AND ALL LIENS OR CLAIMS OF LIENS IT HAS UPON THE FOREGOING DESCRIBED PROPERTY OR ANY RIGHTS AGAINST ANY LABOR AND/OR MATERIAL BOND ON ACCOUNT OF LABOR OR MATERIALS, OR BOTH, FURNISHED BY THE UNDERSIGNED TO OR ON ACCOUNT OF SAID CONTRACTOR FOR SAID PROPERTY. GIVEN UNDER HAND AND SEAL THIS ____ DAY OF ____, ____.

____ (SEAL)

____

____

(WITNESS)

____

(ADDRESS)

NOTICE: WHEN YOU EXECUTE AND SUBMIT THIS DOCUMENT, YOU SHALL BE CONCLUSIVELY DEEMED TO HAVE WAIVED AND RELEASED ANY AND ALL LIENS AND CLAIMS OF LIENS UPON THE FOREGOING DESCRIBED PROPERTY AND ANY RIGHTS REGARDING ANY LABOR OR MATERIAL BOND REGARDING THE SAID PROPERTY TO THE EXTENT (AND ONLY TO THE EXTENT) SET FORTH ABOVE, EVEN IF YOU HAVE NOT ACTUALLY RECEIVED SUCH PAYMENT, 90 DAYS AFTER THE DATE STATED ABOVE UNLESS YOU FILE AN AFFIDAVIT OF NONPAYMENT PRIOR TO THE EXPIRATION OF SUCH 90 DAY PERIOD. THE FAILURE TO INCLUDE THIS NOTICE LANGUAGE ON THE FORM SHALL RENDER THE FORM UNENFORCEABLE AND INVALID AS A WAIVER AND RELEASE UNDER O. C. G. A. § 44-14-366.

Affidavit of Nonpayment O.C.G.A. § 44-14-366 (g)(2)(C), read Nov 12, 2026

STATE OF GEORGIA

COUNTY OF ____

THE UNDERSIGNED MECHANIC AND/OR MATERIALMAN HAS BEEN EMPLOYED BY ____ (NAME OF CONTRACTOR) TO FURNISH ____ (DESCRIBE MATERIALS AND/OR LABOR) FOR THE CONSTRUCTION OF IMPROVEMENTS KNOWN AS ____ (TITLE OF THE PROJECT OR BUILDING) WHICH IS LOCATED IN THE CITY OF ____, COUNTY OF ____, AND IS OWNED BY ____ (NAME OF OWNER) AND MORE PARTICULARLY DESCRIBED AS FOLLOWS:

____

____

____

(DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT NUMBER, OR STREET ADDRESS OF THE PROJECT.)

PURSUANT TO O. C. G. A. § 44-14-366 THE UNDERSIGNED EXECUTED A LIEN WAIVER AND RELEASE WITH RESPECT TO THIS PROPERTY DATED ____, ____. THE AMOUNT SET FORTH IN SAID WAIVER AND RELEASE ($____) HAS NOT BEEN PAID IN FULL AND $____ OF THE AMOUNT SET FORTH IN SAID WAIVER AND RELEASE REMAINS UNPAID, AND THE UNDERSIGNED HEREBY GIVES NOTICE OF SUCH NONPAYMENT. THE ABOVE FACTS ARE SWORN TRUE AND CORRECT BY THE UNDERSIGNED, THIS ____ DAY OF ____, ____.

____ (SEAL)

CLAIMANT’S SIGNATURE

SWORN TO AND EXECUTED

IN THE PRESENCE OF:

____

WITNESS

____

NOTARY PUBLIC

WITHIN SEVEN DAYS OF FILING THIS AFFIDAVIT OF NONPAYMENT, THE FILING PARTY SHALL SEND A COPY OF THE AFFIDAVIT BY REGISTERED OR CERTIFIED MAIL OR STATUTORY OVERNIGHT DELIVERY TO THE OWNER OF THE PROPERTY. IF THE FILING PARTY IS NOT IN PRIVITY OF CONTRACT WITH THE PROPERTY OWNER AND A NOTICE OF COMMENCEMENT IS FILED FOR THE IMPROVEMENT ON THE PROPERTY FOR WHICH THE FILING PARTY’S LABOR, SERVICES, OR MATERIALS WERE FURNISHED, A COPY OF THE AFFIDAVIT SHALL BE SENT TO THE CONTRACTOR AT THE ADDRESS SHOWN ON THE NOTICE OF COMMENCEMENT. WHENEVER THE OWNER OF THE PROPERTY IS AN ENTITY ON FILE WITH THE SECRETARY OF STATE’S CORPORATIONS DIVISION, SENDING A COPY OF THE AFFIDAVIT TO THE COMPANY’S ADDRESS OR THE REGISTERED AGENT’S ADDRESS ON FILE WITH THE SECRETARY OF STATE SHALL BE DEEMED SUFFICIENT.

The filled sample, field by field

The sample beside the introduction is the interim form, (d), for the first pay app of the demo drywall job, Maple Street Clinic: $24,367.50 due after 5% retainage on a job at 1450 Maple Street in Atlanta. The table lists each blank the app filled and where the value came from. The signing day and the seal, witness and address lines stay open for the signer and the witness.

Blank on the formSample valueWhere the app takes it from
County of (opening line)FultonThe project's county
Name of contractorNorthgate Builders Inc.The customer, the party you bill on the project
Materials and/or laborDrywallThe description of the work on the project
Title of the projectMaple Street ClinicThe project's name
City and countyAtlanta, FultonThe city typed on the waiver screen, and the project's county
Name of ownerMaple Street Medical Partners LLCThe project's owner
Description of the propertyMaple Street Clinic, 1450 Maple Street, Atlanta, GA 30303, on the first of the three lines above the captionThe project's name and site address
Upon the receipt of the sum of$24,367.50The pay app's current payment due
Through the date ofOctober 31, 2026The period end date of the pay app
Day, month and year; seal; witness; addressLeft openFilled when the claimant signs and the witness adds their lines

Making a Georgia waiver here

  1. Set the project's State to Georgia when you create the job. The interim form, the final form and the affidavit are then the ones offered for it.
  2. Build the pay application for the period and finish it. A finished pay app is frozen, so the amount on the waiver cannot drift from it.
  3. Open Lien waivers and choose the interim or the final form, and the pay app it is for. The contractor, project, owner, amount and through date fill in.
  4. Check the lines the form leaves to you, such as the property description, the signing day and the witness.
  5. Sign typed or drawn, or send the signing link to the person who signs. The waiver is added to the PDF beside the pay app.
The pay app editor for application 2 on Maple Street Clinic, with the current payment due and retainage rates above and the continuation sheet below

How the waiver follows the pay app

The sum on a Georgia waiver is the payment due on the pay app, after retainage and after every change order, including a deduction. Take a concrete job on its third application, for the period to July 31, 2026. The original contract sum is $160,000.00. One change order added $12,500.00 and a second deducted $4,000.00, so the contract sum to date is $168,500.00. The deduction is a negative line on the continuation sheet, billed as a credit in this period.

Work completed and stored to date is $164,500.00. Retainage at 10% is $16,450.00, which leaves $148,050.00 earned less retainage. The earlier applications asked for $113,625.00, so the current payment due is $34,425.00. The interim waiver for it reads $34,425.00 after the words on the receipt of the sum of, and July 31, 2026 as the through date. The $16,450.00 of retainage sits in the retained amounts the interim form excepts.

If that payment is not received, the affidavit of nonpayment names $34,425.00 as the amount in the waiver and gives the part still unpaid. Because the waiver is made from the finished pay app, the sum on it matches the pay app's current payment due, and a revised pay app makes a new version. The retainage guide follows the held amount, and the pay application guide shows where the current payment due comes from.

Georgia waiver questions

Does a Georgia lien waiver need a notary or a witness?

The two waiver forms carry a seal line, a witness line and an address line, and the statute states no notary block for them. The affidavit of nonpayment carries a notary public line.

When does a Georgia lien waiver take effect?

Under subsection (g)(2), at the earliest of three things: receipt of the amount it states, a separate written acknowledgment of payment in full, or 90 days after it is signed, unless an affidavit of nonpayment is filed before then in the county where the property is located.

What is the Georgia affidavit of nonpayment?

A form in subsection (g)(2)(C) for a claimant who signed a waiver and has not been paid in full. It gives the waiver's date and amount, the part still unpaid, and is sworn before a witness and a notary public. Within seven days of filing, a copy goes to the owner by registered or certified mail or statutory overnight delivery.

Does Georgia set the form a waiver has to follow?

Subsection (c) says a statement purporting to waive or release a lien or bond claim is not enforceable unless it is made on the prescribed form, duly executed, and the claimant has received payment as subsection (g) sets out.

Is the notice paragraph part of the Georgia form?

Yes. Each waiver form ends with a notice about the 90 days and the affidavit of nonpayment, and the notice says that leaving its language off makes the form unenforceable as a waiver under the section.

What type size does a Georgia waiver use?

The statute says the forms are to be in at least 12 point font, and need not be in boldface capital letters.

Does a mistake in a blank undo a Georgia waiver?

Subsection (d) says failing to complete a blank correctly does not undo the form so long as the subject matter of the release can reasonably be determined.

Does the Georgia interim waiver cover retainage?

No. The interim form excepts the rights and liens the claimant might have in any retained amounts. The final form has no such exception.

Sources: O.C.G.A. § 44-14-366.

Other States and the four kinds

The lien waiver guide sets the four kinds side by side, and conditional vs unconditional covers the timing. Neighboring States with their own statutory forms in the app: Florida and Mississippi.