herc-on-the-go Hertz Equipment Rental app now available
for all Apple and Android tablets and smart phones.

Lien Release Request Form

Please complete the information below and a Hertz Equipment Rental representative will be in contact with you to discuss your needs.

* Indicates a required field

Customer Information

First Name : *

Business Name : *

Last Name: *

Customer Name: *

Address 1: *

Email: *

Address 2:

Phone: *

Zip / Postal Code: *

Fax:

Country : *

Select Country

State / Province : *

Select State / Province

Requestor Information

Same as Customer Information

First Name: *

Last Name: *

Jobsite / Project Information

Job Name : *

Address: *

City: *

Country : *

Select Country

Zip / Postal Code: *

State / Province : *

Select State / Province

Release Information:*

Unconditional Final

(All invoices pertaining to the project must be paid. No rental contracts can be open for this project and no unbilled invoices may exist.)

Conditional Final

(Customer is making final payment for unpaid project invoices. Tha Lien Release will not be issued untill payment has cleared our bank for the final payment. If unbilled invoices exist, a conditional progress release will be ussed instead.)

Unconditional Progress

(All invoices must be paid for the requested Progress Through Date.(Example: If Progress Through Date is 12/31/XX, then all invoices must be paid on project through 12/31/XX). If there are unpaid invoices, release restrictions will be modified as needed.)

Conditional Progress

(The release will verify that the customer is making progress payments for the project and will provide the current balance due Hertz for the project. The correct dollar amount must be known for the Progress Through Date requested. When issued, the Lien Release will only identify the payments that have cleared our bank.)

Payment Being Made By:*

Customer

General Contractor

Owner

Joint Check

Dollar Amount of Release: *

Invoice # for Project:

Questions or Comments : *

Lien Release Contact info


Lien Release requests are processed in the order they are recieved. Upon submittal of Lien Release Request, you should recieve confirmation of Hertz Equipment Rental's reciept of your request, either by fax or mail.

For Lien Release Help Please Emailherclienreleasedept@hertz.com and include your Lien Release Request information.

Faxed Lien Release Requests should be sent to 1-800-654-0711. Please donot submit duplicate Lien Release requests.