2017 Code of Virginia
Title 43 - Mechanics' and Certain Other Liens
Chapter 1 - Mechanics' and Materialmen's 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.