Massachusetts lien waiver form: fill in and download the PDF

Pick the form, fill in the blanks and download the Massachusetts statutory text as a PDF. Free, no account.

Form

Partial Waiver and Subordination of Lien (G.L. c. 254, s. 32(4)). Send it with each progress pay app. It takes effect on receipt of the payment it names.

Date signedCountyInvoice or pay application numberOwnerCustomer (who you contracted with)Lender or mortgagee1. Original contract amount ($)2. Approved change orders ($)3. Adjusted contract amount ($)4. Completed to date ($)5. Less retainage ($)6. Total payable to date ($)7. Less previous payments ($)8. Current amount due ($)9. Pending change orders ($)10. Disputed claims ($)ProjectCityPayment amount in wordsPayment amount ($)Pay application dateThrough dateClaimant (your company)Name of the person signingTitle of the person signing

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Published Oct 31, 2026 · 4 min read · By Ludvig Bergerud, builder of PayAppCheck

Massachusetts prescribes one statutory lien waiver form (Massachusetts General Laws chapter 254, section 32(4)). This page lists it, when a subcontractor signs it, what the statute requires on the page and the blanks it has, with a form that fills the statutory text with your figures and downloads the PDF.

The form the statute prescribes

Partial Waiver and Subordination of Lien (G.L. c. 254, s. 32(4)). Send it with each progress pay app. It takes effect on receipt of the payment it names.

What Massachusetts General Laws chapter 254, section 32(4) requires

One form, the partial waiver and subordination of lien, for a person who has filed or recorded a notice of contract under section 2. It must follow the statutory form with no material deviation.

Lines 1 to 10 are the pay application figures. The builder fills lines 1 to 8 from your G702.

It waives lien rights through the payment period you enter, except retainage, unpaid or pending change orders and disputed claims, and subordinates those to the lender through the 25th day after the period.

It is signed under the penalties of perjury. No notary.

The blanks each form has

Partial Waiver and Subordination of Lien: Date signed, County, Invoice or pay application number, Owner, Customer (who you contracted with), Lender or mortgagee, 1. Original contract amount, 2. Approved change orders, 3. Adjusted contract amount, 4. Completed to date, 5. Less retainage, 6. Total payable to date, 7. Less previous payments, 8. Current amount due, 9. Pending change orders, 10. Disputed claims, Project, City, Payment amount in words, Payment amount, Pay application date, Through date, Claimant (your company), Name of the person signing, Title of the person signing.

Fill it from your pay app

Build the pay app in the free builder, and at the end of the form press Make the statutory waiver. Your company, the owner or GC, the project, the period to and the current payment due come over from the G702 into the form, you pick the state and the form, and Send to your GC attaches the waiver to the pay app it belongs to.

We are software, not legal or tax advisors. Verify against your state statute and your accountant.

Build the pay app the waiver goes with, free, and download both.

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