"Clerk, Superior Court of __________________ County
You are authorized and directed to cancel of record the preliminary notice of lien rights which we filed on the property owned by (state name of owner) on (give date) and recorded by you in Book __________________, Page __________________, of preliminary notices kept by you.
This __________________ day of __________________, __________________.
__________________
Lien claimant or attorney"
OCGA § 44-14-362