2015 Code of Virginia
Title 43 - Mechanics' and Certain Other Liens
§ 43-10. Sufficiency of memorandum, affidavit and notice required by § 43-9

The memorandum, affidavit and notice required by § 43-9 shall be sufficient if substantially in form and effect as follows:

Memorandum for Mechanic's Lien Claimed by Sub-subcontractor.

Name of owner: ________________________________________

Address of owner: ________________________________________

Name of general contractor (if any) and subcontractor:

____________________________________________________________

Name of claimant: ________________________________________

Address of claimant: ________________________________________

Contractor license or certificate number of claimant (if applicable):

____________________________________________________________

Issuance date of license or certificate (if applicable):

____________________________________________________________

Expiration date of license or certificate (if applicable):

____________________________________________________________

If no contractor license or certificate number is included, the claimant certifies that such a valid license or certificate is not required by law for the work done for which the benefit of a lien is claimed.

1. Type of materials or services furnished: ______________

____________________________________________________________

2. Amount claimed: $__________

3. Type of structure on which work done or materials furnished:

____________________________________________________________

4. Brief description and location of real property:

____________________________________________________________

5. Date from which interest on above amount is claimed:

Date: ____________________

It is the intent of the claimant to claim the benefit of a lien.

________________________________________ (Name of claimant).

________________________________________ (Signature of claimant or agent for claimant).

Affidavit.

State of Virginia,

County (or city) of ____________________, to wit:

I, ____________________ (notary or other officer) for the county (or city) aforesaid do certify that ____________________ claimant, or ____________________, agent for claimant, this day made oath before me in my county (or city) aforesaid that ____________________ is justly indebted to claimant in the sum of _______________ dollars for the consideration stated in the foregoing memorandum, and that the same is payable as therein stated.

Given under my hand this the __________ day of _______________, 20_____.

________________________________________ (Notary Public or Magistrate, et cetera.)

Notice.

To ____________________ (owner) and ____________________ (general contractor):

You are hereby notified that ____________________, a subcontractor under you, said ____________________ (general contractor) for the construction (or removal, etc.,) of a ____________________ (describe structure) for you, or on property owned by you, said ____________________ (owner) is indebted to me in the sum of _______________ dollars ($__________) with interest thereon from the __________ day of _______________, 20_____, for work done (or materials furnished) in and about the construction (or removal, etc.,) of ____________________ (naming structure), situate in the county (or city) of ____________________ Virginia, and that I have duly recorded a mechanic's lien for the same.

Given under my hand this the __________ day of _______________, 20_____.

________________________________________ (Sub-subcontractor).

Code 1919, § 6429; 1968, c. 568; 1984, c. 647; 2007, c. 504; 2013, c. 293.