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IN THE SUPERIOR COURT OF WALTON COUNTY STATE OF GEORGIA APPLICATION FOR RELEASE OF BOND TO DISCHARGE LIEN IN RE: BOND TO DISCHARGE LIEN FILED as Principal, and with the Clerk of Superior Court of Walton County, Georgia, under O.C.G.A. Section 44-14-364, to Discharge a labor or materialman’s lien filed by in Lien Walton County Records. WHEREAS, the foregoing Bond to Discharge Lien was duly filed with the Clerk of said Court to discharge a lien which was recorded in the amount of and a like sum therefore was deposited with such Clerk by the undersigned as bond; AND WHEREAS, by operation of law the said lien expired on or about no suit having been filed to enforce the same or to levy upon the bond filed with the Clerk of such Court. NOW THEREFORE, the undersigned, having been duly sworn, states that the foregoing is true and makes application to this Honorable Court for the release of the bond money so deposited, because the purpose for which it was given has expired and the bond is now void and of no force and effect. Sworn to and subscribed before me this day Principal (Notary) VERIFICATION BY CLERK, WALTON SUPERIOR COURT As Clerk of Walton Superior Court, I hereby verify that the foregoing statement is consistent with the documents on file in my office. This day of Clerk, Walton Superior Court ORDER AUTHORIZING RETURN OF BOND The foregoing Application and Verification having been read and the same appearing to be in order, I hereby order and direct the Clerk of such Court to issue a check to the Principal of such bond from the Registry of such Court in the amount of releasing the same from such bond. This day of Judge, Walton Superior Court