CANCELLATION / RELEASE OF STATEMENT OF CLAIM OR PRIVILEGE

(Louisiana Mechanics' Lien Release — Private Works Act)

IMPORTANT: Louisiana is a civil law jurisdiction. What other states call "mechanics' liens" are called "privileges" in Louisiana. A "Statement of Claim or Privilege" is the recorded instrument. This document provides forms to cancel or release that recorded privilege.

FORM 1: FULL CANCELLATION OF STATEMENT OF CLAIM OR PRIVILEGE

(After Full Payment — La. R.S. 9:4833)

CANCELLATION OF INSCRIPTION OF STATEMENT OF CLAIM OR PRIVILEGE

STATE OF LOUISIANA
PARISH OF [________________________________]

TO THE RECORDER OF MORTGAGES, PARISH OF [________________________________]:

The undersigned, [________________________________] ("Claimant"), hereby requests the cancellation of the inscription of the Statement of Claim or Privilege described below:

Privilege Information

Cancellation Declaration

The undersigned Claimant hereby acknowledges and declares:

1. Full Payment Received. Claimant has received payment in full in the amount of $[________________________________] in complete satisfaction of all sums due for labor, services, materials, or other obligations giving rise to the privilege described above.

2. Privilege Extinguished. The claim or privilege preserved by the filing of the above-referenced Statement of Claim or Privilege has been fully extinguished by payment pursuant to La. R.S. 9:4823.

3. Request for Cancellation. The Claimant hereby directs the Recorder of Mortgages of the Parish of [________________________________] to cancel the inscription of the Statement of Claim or Privilege identified above from the mortgage records, in accordance with La. R.S. 9:4833.

4. No Further Claims. Claimant has no further claim or privilege against the above-described immovable property or any improvement thereon arising from the work or materials that were the subject of the cancelled Statement of Claim or Privilege.

5. Indemnification. Claimant agrees to indemnify and hold harmless the Owner and the Owner's successors, assigns, and transferees from any loss, cost, or expense, including reasonable attorney fees, resulting from any third-party claim arising from the privilege hereby cancelled.

Claimant Signature

Executed on this [____] day of [________________], 20[____].

CLAIMANT / PRIVILEGE HOLDER:

Signature: ______________________________
Printed Name: [________________________________]
Title: [________________________________]
Company: [________________________________]
Louisiana Contractor License No.: [________________________________]

Notarial Acknowledgment

STATE OF LOUISIANA
PARISH OF [________________________________]

Before me, the undersigned Notary Public, duly commissioned and qualified in and for the Parish and State aforesaid, personally came and appeared:

[________________________________]

who, after being duly sworn, did acknowledge that he/she executed the foregoing Cancellation of Inscription of Statement of Claim or Privilege as his/her free act and deed for the purposes therein expressed.

SWORN TO AND SUBSCRIBED before me on this [____] day of [________________], 20[____].

Notary Public: ______________________________
Printed Name: [________________________________]
Notary Identification / Bar Roll Number: [________________________________]
My Commission: ☐ Life Commission (Louisiana Notary) ☐ Expires: [__/__/____]

(Louisiana notaries typically hold life commissions)

FORM 2: PARTIAL CANCELLATION OF STATEMENT OF CLAIM OR PRIVILEGE

(After Partial Payment)

PARTIAL CANCELLATION AND REDUCTION OF STATEMENT OF CLAIM OR PRIVILEGE

STATE OF LOUISIANA
PARISH OF [________________________________]

TO THE RECORDER OF MORTGAGES, PARISH OF [________________________________]:

Original Privilege Information

Partial Payment and Reduction

The undersigned Claimant acknowledges receipt of partial payment as follows:

Declaration

1. The Claimant has received partial payment of $[________________________________] toward the obligation secured by the above-referenced Statement of Claim or Privilege.

2. The Claimant hereby requests the Recorder of Mortgages to note in the margin of the inscription that the privilege amount has been reduced from $[________________________________] to $[________________________________].

3. The Claimant's privilege remains in effect as to the remaining balance of $[________________________________], plus any interest, costs, and attorney fees to which Claimant may be entitled by law.

4. This Partial Cancellation does not constitute a waiver of any right, privilege, or claim not expressly released herein.

CLAIMANT / PRIVILEGE HOLDER:

Signature: ______________________________
Printed Name: [________________________________]
Title: [________________________________]
Date: [__/__/____]

NOTARIAL ACKNOWLEDGMENT:

(Same form as Form 1 above)

FORM 3: CANCELLATION BY FILING OF BOND OR OTHER SECURITY

(La. R.S. 9:4835 — Owner or Interested Person Posts Security to Cancel Privilege)

NOTICE OF FILING OF BOND OR OTHER SECURITY
AND REQUEST FOR CANCELLATION OF STATEMENT OF CLAIM OR PRIVILEGE

STATE OF LOUISIANA
PARISH OF [________________________________]

TO THE RECORDER OF MORTGAGES, PARISH OF [________________________________]:

Statement of Claim or Privilege to Be Cancelled

Security Deposited

Pursuant to La. R.S. 9:4835, the undersigned hereby deposits with the Recorder of Mortgages the following security to guarantee payment of the obligation secured by the above-referenced privilege:

Type of Security:

☐ Surety Bond — Issued by [________________________________] (surety company authorized to do business in Louisiana), in the penal sum of $[________________________________]

☐ Cash Deposit — In the amount of $[________________________________]

☐ Certified Funds — In the amount of $[________________________________]

Required Amount: The security amount must equal at least 125% of the principal amount of the claim as asserted in the Statement of Claim or Privilege, to cover the principal amount plus interest, costs, and attorney fees. (La. R.S. 9:4835)

Request for Cancellation

The undersigned requests that the Recorder of Mortgages:

1. Examine the bond or other security deposited herewith to determine whether it conforms with the requirements of La. R.S. 9:4835;

2. If in conformity, note approval on the bond and make notation in the margin of the inscription of the Statement of Claim or Privilege;

3. Cancel the inscription of the Statement of Claim or Privilege from the mortgage records.

Notice to Parties

The undersigned certifies that notice of this filing has been or will be given to:

☐ The Owner: [________________________________]
☐ The Privilege Holder / Claimant: [________________________________]
☐ The Principal (General Contractor): [________________________________]

as required by La. R.S. 9:4835.

PERSON FILING SECURITY:

Signature: ______________________________
Printed Name: [________________________________]
Title / Relationship to Property: [________________________________]
Date: [__/__/____]

FORM 4: DEMAND FOR CANCELLATION OF INSCRIPTION

(Letter Demanding Lien Holder Release After Payment — La. R.S. 9:4833)

[LETTERHEAD OR SENDER INFORMATION]

Date: [__/__/____]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA [☐ Hand Delivery ☐ Email ☐ Facsimile]

[________________________________]
[________________________________]
[________________________________]

RE: DEMAND FOR CANCELLATION OF INSCRIPTION OF STATEMENT OF CLAIM OR PRIVILEGE

Property: [________________________________]
Parish: [________________________________]
Instrument No.: [________________________________]
Date Filed: [__/__/____]
Amount Claimed: $[________________________________]

Dear [________________________________]:

I represent [________________________________] ("Owner"), the owner of the above-described immovable property situated in the Parish of [________________________________], State of Louisiana.

NOTICE AND DEMAND

You are hereby notified that the privilege you asserted by filing a Statement of Claim or Privilege with the Recorder of Mortgages for the Parish of [________________________________] on [__/__/____], recorded as Instrument No. [________________________________], has been extinguished for the following reason(s):

☐ Full Payment. The obligation giving rise to your privilege has been paid in full. Payment of $[________________________________] was made on [__/__/____] by [☐ check ☐ wire transfer ☐ ACH ☐ cash ☐ other: ________________].

☐ Expiration / Peremption. Your privilege has perempted because you failed to file suit to enforce the privilege within the time required by La. R.S. 9:4823. The Statement of Claim or Privilege was filed on [__/__/____], and more than one (1) year has elapsed without the filing of an action to enforce the privilege.

☐ Improper Filing. The Statement of Claim or Privilege was improperly filed because: [________________________________].

☐ Other Ground for Extinguishment: [________________________________].

DEMAND FOR WRITTEN REQUEST FOR CANCELLATION

Pursuant to La. R.S. 9:4833, you are hereby required to deliver to the undersigned, within ten (10) days of receipt of this letter, a written request for cancellation in proper form directing the Recorder of Mortgages to cancel the inscription of your Statement of Claim or Privilege.

CONSEQUENCES OF FAILURE TO COMPLY

If you fail to deliver the written request for cancellation within ten (10) days:

1. You will be liable for all damages suffered by the Owner and any other interested person as a result of your refusal, including but not limited to lost sales proceeds, additional carrying costs, financing charges, and attorney fees;

2. The Owner will file a petition for cancellation with the appropriate court, and will seek recovery of all costs and attorney fees incurred;

3. All available legal remedies will be pursued.

This demand is made without waiver of any right, claim, or defense.

Sincerely,

______________________________
[________________________________]
Attorney for [________________________________]
Louisiana Bar Roll No.: [________________________________]
Address: [________________________________]
Telephone: [________________________________]
Email: [________________________________]

FORM 5: PETITION TO CANCEL INSCRIPTION OF STATEMENT OF CLAIM OR PRIVILEGE

(Court Filing — La. R.S. 9:4833; La. C.C.P. art. 3501 et seq.)

[____] JUDICIAL DISTRICT COURT
PARISH OF [________________________________]
STATE OF LOUISIANA

DOCKET NO.: [________________________________]
DIVISION: [____]

[________________________________],
Petitioner,

v.

[________________________________],
Respondent.

PETITION TO CANCEL INSCRIPTION OF STATEMENT OF CLAIM OR PRIVILEGE AND FOR DAMAGES

NOW INTO COURT, through undersigned counsel, comes Petitioner, [________________________________] ("Petitioner"), who respectfully represents:

I. PARTIES AND JURISDICTION

1. Petitioner is [________________________________] [individual/entity description], domiciled/located in [________________________________], Parish of [________________________________], State of Louisiana.

2. Respondent is [________________________________], domiciled/located at [________________________________].

3. This Honorable Court has jurisdiction and venue over this matter pursuant to La. R.S. 9:4833 and La. C.C.P. art. 3501 et seq.

II. PROPERTY DESCRIPTION

4. Petitioner is the owner of immovable property described as follows:

[________________________________]
[________________________________]
[________________________________]

bearing the municipal address of [________________________________], situated in the Parish of [________________________________], State of Louisiana.

III. STATEMENT OF CLAIM OR PRIVILEGE AT ISSUE

5. On or about [__/__/____], Respondent filed a Statement of Claim or Privilege with the Recorder of Mortgages for the Parish of [________________________________], recorded as Instrument No. [________________________________], asserting a privilege against Petitioner's immovable property in the amount of $[________________________________].

6. The Statement of Claim or Privilege purported to secure an obligation arising from [________________________________] [describe nature of work/materials].

IV. GROUNDS FOR CANCELLATION

7. The privilege asserted by Respondent has been extinguished and the inscription should be cancelled for the following reason(s):

☐ a. Full Payment (La. R.S. 9:4823). Petitioner (or a third party) has paid the obligation in full. Payment of $[________________________________] was tendered on [__/__/____]. Respondent has acknowledged receipt of payment but has refused or failed to provide a written request for cancellation.

☐ b. Peremption (La. R.S. 9:4823). Respondent failed to institute an action to enforce the privilege within the peremptive period. The Statement of Claim or Privilege was filed on [__/__/____], and the applicable peremptive period of [☐ one year ☐ other: ____________] has expired without Respondent filing suit.

☐ c. Improper Filing. The Statement of Claim or Privilege fails to comply with the requirements of La. R.S. 9:4822 because: [________________________________].

☐ d. No Valid Privilege. Respondent does not hold a valid privilege under the Private Works Act because: [________________________________].

☐ e. Failure to Respond to Demand. Petitioner delivered a written demand for cancellation to Respondent on [__/__/____], pursuant to La. R.S. 9:4833, and Respondent has failed to deliver a written request for cancellation within ten (10) days.

V. DAMAGES

8. By reason of Respondent's wrongful refusal to cancel the inscription, Petitioner has suffered damages including:

☐ Lost sale of property: $[________________________________]
☐ Additional carrying costs: $[________________________________]
☐ Additional financing costs: $[________________________________]
☐ Title insurance complications: $[________________________________]
☐ Attorney fees and costs: $[________________________________]
☐ Other damages: [________________________________]

VI. PRAYER FOR RELIEF

WHEREFORE, Petitioner respectfully prays that:

A. This Court order the Recorder of Mortgages for the Parish of [________________________________] to cancel the inscription of the Statement of Claim or Privilege filed by Respondent, recorded as Instrument No. [________________________________];

B. Respondent be cast in judgment for all damages suffered by Petitioner in the amount of $[________________________________], or such amount as may be proven at trial;

C. Respondent be cast for all costs of these proceedings, including reasonable attorney fees;

D. Petitioner be granted all such further relief as equity and justice may require.

Respectfully submitted,

______________________________
[________________________________]
Attorney for Petitioner
Louisiana Bar Roll No.: [________________________________]
Address: [________________________________]
Telephone: [________________________________]
Email: [________________________________]

VERIFICATION

STATE OF LOUISIANA
PARISH OF [________________________________]

Before me, the undersigned Notary Public, personally came and appeared [________________________________], Petitioner herein, who after being duly sworn, declared that the facts stated in the foregoing Petition are true and correct to the best of his/her knowledge, information, and belief.

Signature: ______________________________
Printed Name: [________________________________]

SWORN TO AND SUBSCRIBED before me on this [____] day of [________________], 20[____].

Notary Public: ______________________________

RECORDING INSTRUCTIONS — LOUISIANA

Where to Record

Document Requirements

☐ Document must be in writing and signed by the Claimant / Privilege Holder
☐ Signature must be notarized (authentic act or acknowledged act)
☐ Must reference the original Statement of Claim or Privilege by instrument number
☐ Must include a legal description of the immovable property
☐ Must be presented in original form (parishes may require duplicate originals)
☐ Recording fees vary by parish — contact the Recorder of Mortgages for current fee schedule

Special Notes for Louisiana

☐ Louisiana notaries typically hold life commissions — no expiration date is required
☐ Louisiana attorneys are also notaries by operation of law upon admission to the bar
☐ Marginal notations: The Recorder of Mortgages may make a marginal notation on the original inscription rather than recording a separate cancellation instrument — confirm local practice
☐ The Recorder of Mortgages is a separate office from the Clerk of Court in some parishes

STATUTORY DEADLINES AND PENALTIES — LOUISIANA

PRACTITIONER NOTES — LOUISIANA

Louisiana-Specific Terminology

Louisiana is the only U.S. state governed by civil law (derived from French and Spanish law). Practitioners must use correct terminology:

Key Practice Points

1. Peremption vs. Prescription. Louisiana privileges are subject to peremption (not prescription). Unlike prescription, peremption cannot be interrupted or suspended. If the privilege holder does not file suit within one year from the filing of the Statement of Claim or Privilege, the privilege is extinguished by operation of law.

2. Recorder of Mortgages vs. Clerk of Court. The cancellation instrument must be filed with the Recorder of Mortgages — not the Clerk of Court. In some parishes, these are the same office; in others (notably Orleans Parish), they are separate.

3. Bond Security. Under La. R.S. 9:4835, a bond or other security of 125% of the principal claim amount can be deposited to cancel the inscription. This is higher than many states' requirements.

4. Notice of Contract. Whether a Notice of Contract was properly filed affects the deadlines for both filing and peremption of the privilege. Always verify whether a Notice of Contract was filed and, if so, when.

5. 2019 Amendments. The Private Works Act was significantly amended effective January 1, 2020 (2019 La. Acts No. 325, HB 203). Confirm that deadlines and procedures comply with the current version of the statute.

6. Multiple Parishes. If the property is situated in more than one parish, the cancellation must be filed in all parishes where the original Statement of Claim or Privilege was inscribed.

7. Automatic Cancellation. After peremption has occurred, an owner may request the Recorder of Mortgages to cancel the inscription without the cooperation of the privilege holder, provided that the peremptive period has clearly expired and no suit has been filed.

8. Professional Consultants. Architects, engineers, surveyors, and other professional consultants have privilege rights under the Private Works Act. Their privileges are cancelled using the same procedures as contractor privileges.

DISCLAIMER: This template is provided for informational purposes only and does not constitute legal advice. Louisiana's Private Works Act contains unique civil law concepts that differ significantly from common law mechanics' lien statutes. Consult a Louisiana-licensed attorney before using any of these forms.

Sources and References:
- Louisiana Private Works Act (La. R.S. 9:4801 et seq.)
- La. R.S. 9:4833 — Cancellation of Inscription
- La. R.S. 9:4835 — Bond or Other Security
- Louisiana Law Blog — Private Works Act Liens