Mississippi lien waiver forms and what the statute says

Mississippi prints two lien waiver forms in Miss. Code § 85-7-433: an interim waiver and release upon payment, and a waiver and release upon final payment. The same section prints a third form, the affidavit of nonpayment, which a claimant files when the payment named in a waiver never arrived.

Mississippi has no separate conditional and unconditional pair. The interim form stands where other States put their progress waiver, and the final form where they put the final one. In the app, a project located in Mississippi gets all three forms with the statute’s words unchanged, filled from the pay app the payment is for.

The three Mississippi forms at a glance

Each form has its own subsection of § 85-7-433. The right-hand column quotes a line from the form itself that says what it releases or what it gives notice of. Those are the statute’s words, not ours.

The interim form releases liens and bond rights through a date written on it, and it leaves out whatever rights the signer has in retained amounts. The final form has no date and no retained-amount exception: it releases for the labor or materials furnished to the contractor for the property. The affidavit releases nothing. It tells the owner that a sum named in an earlier waiver has not been paid.

The kind pages treat the interim form as Mississippi’s entry beside the conditional progress waiver, and the final form as its entry beside the conditional final waiver. That grouping is ours. The statute itself uses the words interim and final.

The sixty-day notice on each waiver

Both waiver forms end with a notice, and the notice is what sets Mississippi apart from the conditional forms of other States. It says that the signer is CONCLUSIVELY DEEMED TO HAVE BEEN PAID IN FULL THE AMOUNT STATED ABOVE, EVEN IF YOU HAVE NOT ACTUALLY RECEIVED THE PAYMENT, sixty days after the date stated on the form, unless an affidavit of nonpayment or a claim of lien is filed before the sixty days are over.

The notice also says what follows when it is left off: THE FAILURE TO INCLUDE THIS NOTICE LANGUAGE ON THE FACE OF THE FORM SHALL RENDER THE FORM UNENFORCEABLE AND INVALID AS A WAIVER AND RELEASE UNDER SECTION 85-7-419, MISSISSIPPI CODE OF 1972. The app prints the notice on both waiver forms, in the statute’s capitals.

The affidavit of nonpayment is the form that answers the notice. Its closing lines carry a mailing instruction: within two days of filing it, the filing party sends a copy to the owner of the property by registered or certified mail or statutory overnight delivery. Where the owner is an entity on file with the Secretary of State, a copy sent to the company’s address or its registered agent’s address on file there is treated as sufficient.

What the section says about using them

Statute

Miss. Code § 85-7-433

Use of the form

The section does not say. The notice on each form says a form without that notice is not enforceable as a waiver and release.

Who it applies to

The section names no limit.

Notary

Each waiver form and the affidavit of nonpayment carry a notary block.

Note

The notice on each waiver form says the claimant is treated as paid in full the amount stated 60 days after the date stated on the form, unless an affidavit of nonpayment or a claim of lien is filed before then (85-7-433(1), (2)). The affidavit form is offered here.

Source: Miss. Code § 85-7-433. As published by Justia, 2025 edition (FindLaw’s copy is the same), read Nov 12, 2026.

Two details of the forms bear on retainage and signing. The interim form excepts THOSE RIGHTS AND LIENS THAT THE MECHANIC AND/OR MATERIALMAN MIGHT HAVE IN ANY RETAINED AMOUNTS, so the retainage a GC holds back stays outside it. The final form carries no such sentence.

Each waiver form and the affidavit also has a notary block, a line for the notary to complete after the words SWORN TO AND SUBSCRIBED BEFORE ME. The final form prints its notice and then a second signature block with a second notary block. The app prints both, in the order the statute gives them. The section’s history line reads Laws, 2014, ch. 487, § 17; Laws, 2015, ch. 348, § 1, eff from and after July 1, 2015.

The full text of each form

Below is each Mississippi form as the app prints it, word for word. The blank lines are where the app writes the job’s details, and the headings inside each form are the statute’s own. Every form opens with the State and the county. The property is described by a metes and bounds description, a land lot district with block and lot number, or the street address of the project, and the app writes the street address.

The filled sample, field by field

The sample beside the introduction is the interim waiver for the first pay app of the demo drywall job, Maple Street Clinic: $25,650.00 of work, 5% retainage held, $24,367.50 due. The job is at 1450 Maple Street in Jackson. These are the blanks the app filled, and where each value came from.

Making a Mississippi waiver here

1. Create the project with Mississippi as its State. The interim form, the final form and the affidavit are the ones offered for it.
2. Finish the pay app for the period. A finished pay app is frozen, so the waiver is built from figures that no longer move.
3. Open Lien waivers and pick the form and the pay app. The sum, the date, the contractor, the owner and the property lines fill in.
4. Check the filled blanks, then sign typed or drawn, or send a signing link to the person who signs.
5. Download the PDF. The waiver and any backup files you attached go into the same file as the pay app, with the notary block printed for a notary to complete.

How the waiver follows the pay app

The sum on the interim waiver is the payment the pay app asks for, not the contract sum and not the work to date. Take the second pay app of the pay application guide’s drywall job, at 10% retainage, for the period to February 28, 2026. It shows $76,000.00 completed to date on a $120,000.00 contract, $7,600.00 of retainage held, and $23,085.00 certified on the first application. The current payment due is $45,315.00.

The interim waiver for that payment reads $45,315.00 as the sum and February 28, 2026 as the date. The $7,600.00 of retainage is outside the payment, and the interim form excepts retained amounts in its own words. When the retainage is paid at the end of the job, the final waiver is the form that goes with that payment. The retainage guide follows a release through a job.

Because the waiver is made from a finished pay app, the two papers cannot drift apart. A revised pay app makes a new version, and a new Mississippi waiver can be made from it. The pay application guide shows where the current payment due comes from, line by line.

Sources: Miss. Code § 85-7-433.

Other States and the four kinds

Beyond Mississippi, the lien waiver guide sets out the four kinds side by side, and conditional vs unconditional covers the timing. Two other States whose forms differ from Mississippi’s are Georgia, which also has an interim and a final form, and Missouri.

We print the statute’s wording and the facts above and say nothing about which waiver to sign.