Simple Pay ApplicationMassachusetts lien waiver form and what the statute says
Massachusetts has one lien waiver form in its statute, the Partial Waiver and Subordination of Lien in M.G.L. c. 254, s. 32(4). It is a partial waiver that also subordinates, and the statute gives no separate form for a final payment and no conditional or unconditional versions.
The form is written for persons who have filed or recorded a notice of contract under section 2 of the chapter. A project located in Massachusetts gets it in the app with the statute’s words unchanged, and the first eight lines of its table fill from the pay app the payment is for. For the other kinds, the app offers our own general forms.
The one Massachusetts form at a glance
Section 32 holds a single form, so the table has one row. Its last column quotes the statute on the people and the situation the form is for.
| Form | Section | Nearest kind | When the statute uses it, in its words |
|---|---|---|---|
| Partial Waiver and Subordination of Lien | M.G.L. c. 254, s. 32(4) | A progress payment, with a subordination added | “partial waivers and subordinations of liens given by persons who have filed or recorded notices of contract under section two substantially in the following form with no material deviation therefrom” |
Section 32 approaches the subject from the other side. A promise in or alongside a contract that bars the filing of a notice of contract, bars the steps to enforce a lien, or subordinates lien rights to the rights of other persons is against public policy and is void and unenforceable
. The section then lists what it does not reach. Clause (4) of that list is this form. Clause (1) is another entry: waivers given by a person named as principal on a lien bond under section 12, in connection with an interim or final payment. The statute prints no form for those.
The section ends with a sentence about everyone else on the job: The giving of a partial waiver and subordination of lien by any contractor under this section shall not affect the lien rights of any other person claiming a lien under any section of this chapter.
- Statute
- M.G.L. c. 254, s. 32(4)
- Use of the form
- The statute gives the form.
- Who it applies to
- Persons who filed or recorded a notice of contract under section 2.
- Notary
- Signed under the penalties of perjury; the statute names no notary.
Source: M.G.L. c. 254, s. 32(4). The Massachusetts Legislature’s site, read Nov 12, 2026.
What is in the form, and what the statute leaves out
The form has four parts. A header block gives the date, the county, the application for payment number, and the names of the owner, the contractor and the lender or mortgagee. A table of ten lines follows. Then comes one long sentence naming the contract, the property and the payment, and closing with two paragraphs, (a) and (b), and a signing line.
Paragraph (a) waives liens and the right of lien for labor, materials or rental equipment through a payment period date, except for retainage, unpaid agreed or pending change orders, and disputed claims as stated above
. Paragraph (b) subordinates lien rights for those unpaid or pending change orders and disputed claims, and for further labor or materials other than retainage, through the twenty-fifth day after the end of the payment period. It does so to the extent of the amount the lender or mortgagee actually advanced through that twenty-fifth day.
The sentence that carries both paragraphs names the payment it is given for: upon receipt of ___ ($___) in payment of an invoice/requisition/application for payment dated ___
. So the amount, in words and in figures, and the date of the application sit on the form itself.
Three things are absent. The statute names no notary: the form ends with Signed under the penalties of perjury
and a day, a month and a year. It sets no type size and no capitals or bold for any part. And it has no form for a final payment. Where a Massachusetts project needs a kind the statute does not cover, the app offers one of our general forms, which are written by us and are not the legislature’s words.
The full text of the form
This is the form as the app prints it, word for word. The marks <pwrule;10> and <pwrule;5> come from the legislature’s page, where they stand for ruled blanks: one for the owner’s name after “owned by”, and two for the month and the year of the signing day. The PDF fills the owner and leaves the month and year as lines.
Partial Waiver and Subordination of Lien M.G.L. c. 254, s. 32(4), read Nov 12, 2026
Partial Waiver and Subordination of Lien
COMMONWEALTH OF MASSACHUSETTS: Date: _____________
__________ COUNTY Application for Payment No: ____________
OWNER: _______________________________
CONTRACTOR: _________________________
LENDER/MORTGAGEE: ________________
1. Original Contract Amount: _________
2. Approved Change Orders: _________
3. Adjusted Contract Amount: _________
(line 1 plus 2)
4. Completed to Date: _________
5. Less Retainage: _________
6. Total Payable to Date: _________
(line 4 less line 5)
7. Less Previous Payments: _________
8. Current Amount Due: _________
(line 6 less line 7)
9. Pending Change Orders: _________
10. Disputed Claims: _________
The undersigned who has a contract with ___ for furnishing labor or materials or both labor and materials or rental equipment, appliances or tools for the erection, alteration, repair or removal of a building or structure or other improvement of real property known and identified as ___ located in ___ (city or town), ___ County, Commonwealth of Massachusetts and owned by <pwrule;10>, upon receipt of ___ ($___) in payment of an invoice/requisition/application for payment dated ___ does hereby:
(a) waive any and all liens and right of lien on such real property for labor or materials, or both labor and materials, or rental equipment, appliances or tools, performed or furnished through the following date: ___ (payment period), except for retainage, unpaid agreed or pending change orders, and disputed claims as stated above; and
(b) subordinate any and all liens and right of lien to secure payment for such unpaid, agreed or pending change orders and disputed claims, and such further labor or materials, or both labor and materials, or rental equipment, appliances or tools, except for retainage, performed or furnished at any time through the twenty-fifth day after the end of the above payment period, to the extent of the amount actually advanced by the above lender/mortgagee through such twenty-fifth day.
Signed under the penalties of perjury this ___ day of <pwrule;5>, <pwrule;5>.
The filled sample, field by field
The sample beside the introduction is the first pay app of the demo drywall job, Maple Street Clinic: $25,650 of work, 5% retainage held, $24,367.50 due. Lines 1 to 8 of the form are the first eight lines of the pay app’s summary, in the same order, so the numbers on both pages carry the same line numbers.
| Form line | Pay app summary line | Sample value |
|---|---|---|
| 1. Original Contract Amount | 1, Original contract sum | $120,000.00 |
| 2. Approved Change Orders | 2, Net change by change orders | $0.00 |
| 3. Adjusted Contract Amount | 3, Contract sum to date | $120,000.00 |
| 4. Completed to Date | 4, Total completed and stored to date | $25,650.00 |
| 5. Less Retainage | 5, Retainage | $1,282.50 |
| 6. Total Payable to Date | 6, Total earned less retainage | $24,367.50 |
| 7. Less Previous Payments | 7, Less previous applications | $0.00 |
| 8. Current Amount Due | 8, Current payment due | $24,367.50 |
| 9. Pending Change Orders | No matching line; typed on the waiver screen | None |
| 10. Disputed Claims | No matching line; typed on the waiver screen | 0.00 |
Line 9 of the pay app, the balance to finish, has no place on the form. The form’s own lines 9 and 10 have no figure in the pay app, and the sample leaves both empty. The rest of the blanks are names, places and dates:
| Blank on the form | Sample value | Where the app takes it from |
|---|---|---|
| County in the header | Worcester | The project’s location |
| Application for Payment No. | 1 | The number of the pay app |
| Owner | Maple Street Medical Partners LLC | The owner set on the project |
| Contractor, and the party the contract is with | Northgate Builders Inc. | The party you bill on the project, usually the GC |
| Property known and identified as | Maple Street Clinic | The project’s name |
| City or town, and county | Worcester, Worcester | The city typed on the waiver screen, and the project’s county |
| Upon receipt of the amount, in figures | $24,367.50 | The pay app’s current payment due |
| Application for payment dated, and payment period | October 31, 2026 for both | The pay app’s dates, the period end for the payment period |
| Amount in words | Twenty-three thousand eighty-five and 00/100 dollars | The pay app’s current payment due, written out |
| Lender or mortgagee | None | Typed on the waiver screen |
| Date and signing day | Left open | Filled when the signer signs |
| Claimant, signer and title | Delta Line Drywall LLC, Dana Reyes, Office manager | Your company on the account, and the person who signs |
Making a Massachusetts waiver here
- Choose Massachusetts as the project’s State when you set up the job. The Partial Waiver and Subordination of Lien becomes the form offered for it.
- Finish the pay app for the period. Its figures freeze, and the waiver reads them from there.
- Open Lien waivers, pick that pay app and the form. Lines 1 to 8, the names, the property and the dates fill in.
- Type the lines the pay app has no figure for: the lender or mortgagee, pending change orders and disputed claims, with None or 0.00 where there is nothing to state.
- Sign typed or drawn, or send a signing link to the person who signs, then download the PDF with the pay app and its backup files.
How the waiver follows the pay app
The figures on the form are the pay app’s, copied once the pay app is finished. Take a sub on a $160,000 job whose third pay app, for the period to July 31, 2026, carries two change orders signed by both parties: a $12,500 addition billed on an earlier pay app and a $4,000 deduction entered on this one. The pay app’s summary shows additions and deductions apart. The Massachusetts form has one line for them, line 2, so it shows the net, $8,500.
| 1Original contract sum | $160,000.00 |
| 2Net change by change orders | $8,500.00 |
| 3Contract sum to date | $168,500.00 |
| 4Total completed and stored to date | $164,500.00 |
| 5Retainage at 10% | $16,450.00 |
| 6Total earned less retainage | $148,050.00 |
| 7Less previous applications | $113,625.00 |
| 8Current payment due | $34,425.00 |
The waiver made from this pay app puts $34,425.00 in the receipt blank and July 31, 2026 in the payment period blank. Line 5 shows the $16,450.00 of retainage held, and paragraph (a) of the form excepts retainage from what it waives. The pay app’s ninth line, a balance to finish of $20,450.00, is not on the form.
When retainage is released on a later pay app, the release is part of that pay app’s payment due, and line 5 falls by the amount released. On the fourth and last pay app of the $120,000 drywall job, which only releases retainage, the release of $12,000 makes line 8 $12,000.00, line 5 $0.00 and line 7 $108,000.00. Those are the lines a waiver made from that pay app carries.
A finished pay app is frozen, so the two documents cannot drift apart. A revision makes a new pay app version, and a new waiver can be made from it. The pay application guide goes through each summary line, and the retainage guide covers rate changes and releases.
Massachusetts waiver questions
Does Massachusetts have a final lien waiver form in its statute?
No. Section 32(4) gives one form, the Partial Waiver and Subordination of Lien, and nothing for a final payment. For the other kinds the app offers our own general forms, which are not the legislature’s words.
Who is the Massachusetts form written for?
For persons who have filed or recorded a notice of contract under section 2 of chapter 254. The statute does not describe it as a form for every claimant.
Does a Massachusetts lien waiver need a notary?
The statute names no notary. The form closes with a line saying it is signed under the penalties of perjury, followed by a day, a month and a year.
Does the form cover retainage?
Paragraph (a) waives liens through the payment period date, except for retainage, unpaid agreed or pending change orders and disputed claims as stated above. Line 5 of the form shows the retainage held.
What does the subordination in paragraph (b) say?
It subordinates lien rights for unpaid or pending change orders and disputed claims, and for further work other than retainage, through the twenty-fifth day after the payment period ends. The limit is the amount the lender or mortgagee actually advanced through that day.
What goes in the payment period date?
The date the waiver runs through. The app fills it with the period end date of the pay app the payment is for, which is October 31, 2026 in the sample.
Does one contractor’s waiver affect other people’s lien rights?
The last sentence of section 32 says a partial waiver and subordination given by a contractor shall not affect the lien rights of any other person claiming a lien under the chapter.
How closely does a waiver follow the statute’s wording?
Clause (4) speaks of a form substantially like the one printed, with no material deviation from it. The app prints the statute’s words unchanged and fills only the blanks.
Sources: M.G.L. c. 254, s. 32(4).
Nearby States and the other kinds
Because the statute’s form is a partial waiver, the conditional progress and unconditional progress pages list it as the Massachusetts form for a progress payment. The lien waiver guide compares all four kinds, and conditional vs unconditional covers when each takes effect. Next to Massachusetts on the State list are Georgia and Michigan.