{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2026\/code-json\/43-5.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2026\/code-text\/43-5.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2026\/code-xml\/43-5.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2026\/code-html\/43-5.html"}],"law_id":363700,"edition_id":2,"section_id":363700,"structure_id":51889,"section_number":"43-5","catch_line":"Sufficiency of memorandum and affidavit required by \u00a7 43-4","history":"Code 1919, \u00a7 6427; 1940, p. 402; 1968, c. 568; 2007, c. 504; 2013, c. 293; 2019, c. 243.","full_text":"The memorandum and affidavit required by \u00a7 43-4 shall be sufficient if substantially in form and effect as follows:\n\n\t\tMemorandum for Mechanic&#8217;s Lien Claimed by General Contractor.\n\n\t\tName of owner: ___________________________________________________________________________\n\n\t\tAddress of owner: ___________________________________________________________________________\n\n\t\tName of claimant: ___________________________________________________________________________\n\n\t\tAddress of claimant: ___________________________________________________________________________\n\n\t\tContractor license or certificate number of claimant\n\n\t\t(if applicable): ___________________________________________________________________________\n\n\t\tIssuance date of license or certificate\n\n\t\t(if applicable): ___________________________________________________________________________\n\n\t\tExpiration date of license or certificate\n\n\t\t(if applicable): ___________________________________________________________________________\n\n\t\tIf 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.\n\n1\n\nType of materials or services furnished: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________\n\t\t\t___________________________________________________________________________\n\n\t\t\t___________________________________________________________________________\n\n2\n\nAmount claimed:  $ ___________________________________________________________________________\n\t\t\tIf any part of the Amount claimed is not due as of the date of this mechanic&#8217;s lien, identify the date or event upon which it will be due and the sum(s) to which the due date(s) or event(s) apply: ___________________________________________________________________________\n\n3\n\nType of structure on which work done or materials furnished: ___________________________________________________________________________\n\t\t\t___________________________________________________________________________\n\n4\n\nBrief description and location of real property:\n\t\t\t___________________________________________________________________________\n\n5\n\nDate from which interest on the above amount is claimed:\n\t\t\tDate: _______________________\n\n\t\t\tIt is the intent of the claimant to claim the benefit of a lien.\n\n\t\t\tThe undersigned hereby certifies that he has mailed a copy of this memorandum of lien to the owner of the property at the owner&#8217;s last known address: &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;. (address), on &#8230;&#8230;..   (date of mailing).\n\n\t\t\t___________________________________________________________________________  (Name of claimant).\n\n\t\t\tAffidavit.\n\n\t\t\tState of Virginia,\n\n\t\t\tCounty (or city) of &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;,  to wit:\n\n\t\t\tI, _______________________  (notary or other officer) for the county (or city) aforesaid, do certify that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.  claimant, or &#8230;&#8230;&#8230;&#8230;&#8230;., agent for claimant, this day made oath before me in my county (or city) aforesaid that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; (the owner) is justly indebted to claimant in the sum of &#8230;&#8230;&#8230;&#8230;.. dollars, for the consideration stated in the foregoing memorandum, and that the same is payable as therein stated.\n\n\t\t\tGiven under my hand this the &#8230;&#8230;.. day of &#8230;&#8230;&#8230;&#8230;&#8230;.., 20&#8230;.\n\n\t\t\t___________________________________________________________________________ (Notary Public or Magistrate, et cetera.)\n\n","order_by":null,"text":{"0":{"id":1354970,"text":"The memorandum and affidavit required by \u00a7 43-4 shall be sufficient if substantially in form and effect as follows:\t\tMemorandum for Mechanic&#8217;s Lien Claimed by General Contractor.\t\tName of owner: ___________________________________________________________________________\t\tAddress of owner: ___________________________________________________________________________\t\tName of claimant: ___________________________________________________________________________\t\tAddress of claimant: ___________________________________________________________________________\t\tContractor license or certificate number of claimant\t\t(if applicable): ___________________________________________________________________________\t\tIssuance date of license or certificate\t\t(if applicable): ___________________________________________________________________________\t\tExpiration date of license or certificate\t\t(if applicable): ___________________________________________________________________________\t\tIf 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.","type":"section","prefixes":[""],"prefix":"","entire_prefix":"","prefix_anchor":"","level":1,"next_prefix":"1"},"1":{"id":1354971,"text":"Type of materials or services furnished: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________\n\t\t\t___________________________________________________________________________\t\t\t___________________________________________________________________________","type":"section","prefixes":["1"],"prefix":"1","entire_prefix":"1","prefix_anchor":"1","level":1,"prior_prefix":"","next_prefix":"2"},"2":{"id":1354972,"text":"Amount claimed:  $ ___________________________________________________________________________\n\t\t\tIf any part of the Amount claimed is not due as of the date of this mechanic&#8217;s lien, identify the date or event upon which it will be due and the sum(s) to which the due date(s) or event(s) apply: ___________________________________________________________________________","type":"section","prefixes":["2"],"prefix":"2","entire_prefix":"2","prefix_anchor":"2","level":1,"prior_prefix":"1","next_prefix":"3"},"3":{"id":1354973,"text":"Type of structure on which work done or materials furnished: ___________________________________________________________________________\n\t\t\t___________________________________________________________________________","type":"section","prefixes":["3"],"prefix":"3","entire_prefix":"3","prefix_anchor":"3","level":1,"prior_prefix":"2","next_prefix":"4"},"4":{"id":1354974,"text":"Brief description and location of real property:\n\t\t\t___________________________________________________________________________","type":"section","prefixes":["4"],"prefix":"4","entire_prefix":"4","prefix_anchor":"4","level":1,"prior_prefix":"3","next_prefix":"5"},"5":{"id":1354975,"text":"Date from which interest on the above amount is claimed:\n\t\t\tDate: _______________________\t\t\tIt is the intent of the claimant to claim the benefit of a lien.\t\t\tThe undersigned hereby certifies that he has mailed a copy of this memorandum of lien to the owner of the property at the owner&#8217;s last known address: &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;. (address), on &#8230;&#8230;..   (date of mailing).\t\t\t___________________________________________________________________________  (Name of claimant).\t\t\tAffidavit.\t\t\tState of Virginia,\t\t\tCounty (or city) of &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;,  to wit:\t\t\tI, _______________________  (notary or other officer) for the county (or city) aforesaid, do certify that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.  claimant, or &#8230;&#8230;&#8230;&#8230;&#8230;., agent for claimant, this day made oath before me in my county (or city) aforesaid that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; (the owner) is justly indebted to claimant in the sum of &#8230;&#8230;&#8230;&#8230;.. dollars, for the consideration stated in the foregoing memorandum, and that the same is payable as therein stated.\t\t\tGiven under my hand this the &#8230;&#8230;.. day of &#8230;&#8230;&#8230;&#8230;&#8230;.., 20&#8230;.\t\t\t___________________________________________________________________________ (Notary Public or Magistrate, et cetera.)","type":"section","prefixes":["5"],"prefix":"5","entire_prefix":"5","prefix_anchor":"5","level":1,"prior_prefix":"4"}},"ancestry":[{"id":51889,"edition_id":2,"name":"Mechanics' and Materialmen's Liens","identifier":"1","label":"chapter","depth":2,"order_by":1,"parent_id":51888,"metadata":{"child_laws":32,"child_structures":0},"date_created":"2026-08-02 02:50:42","date_modified":"2026-08-02 12:33:28","permalink":{"id":1448269,"object_type":"structure","relational_id":51889,"identifier":"1","token":"43\/1","url":"\/43\/1\/","edition_id":2,"permalink":0,"preferred":1}},{"id":51888,"edition_id":2,"name":"Mechanics' and Certain Other Liens","identifier":"43","label":"title","depth":1,"order_by":95,"parent_id":null,"metadata":{"child_laws":66,"child_structures":9},"date_created":"2026-08-02 02:50:42","date_modified":"2026-08-02 12:33:27","permalink":{"id":1448267,"object_type":"structure","relational_id":51888,"identifier":"43","token":"43","url":"\/43\/","edition_id":2,"permalink":0,"preferred":1}}],"structure_contents":[{"id":363650,"structure_id":51889,"section_number":"43-1","catch_line":"Definitions","url":"\/43-1\/","token":"43\/1\/43-1","metadata":false},{"id":363651,"structure_id":51889,"section_number":"43-10","catch_line":"Sufficiency of memorandum, affidavit and notice required by \u00a7 43-9","url":"\/43-10\/","token":"43\/1\/43-10","metadata":false},{"id":363652,"structure_id":51889,"section_number":"43-11","catch_line":"How owner or general contractor made personally liable to subcontractor, laborer or materialman","url":"\/43-11\/","token":"43\/1\/43-11","metadata":false},{"id":363653,"structure_id":51889,"section_number":"43-12","catch_line":"Repealed","url":"\/43-12\/","token":"43\/1\/43-12","metadata":false},{"id":363657,"structure_id":51889,"section_number":"43-13","catch_line":"Funds paid to general contractor or subcontractor must be used to pay persons performing labor or furnishing material","url":"\/43-13\/","token":"43\/1\/43-13","metadata":false},{"id":363654,"structure_id":51889,"section_number":"43-13.1","catch_line":"Use of lien waiver form; forgery or signing without authority","url":"\/43-13.1\/","token":"43\/1\/43-13.1","metadata":false},{"id":363655,"structure_id":51889,"section_number":"43-13.2","catch_line":"When an affidavit or a signed statement of payment required of owner prior to sale","url":"\/43-13.2\/","token":"43\/1\/43-13.2","metadata":false},{"id":363656,"structure_id":51889,"section_number":"43-13.3","catch_line":"An affidavit or a signed statement of payment required of owner prior to sale or refinance; penalty","url":"\/43-13.3\/","token":"43\/1\/43-13.3","metadata":false},{"id":363659,"structure_id":51889,"section_number":"43-14","catch_line":"Repealed","url":"\/43-14\/","token":"43\/1\/43-14","metadata":false},{"id":363658,"structure_id":51889,"section_number":"43-14.1","catch_line":"Service of notices","url":"\/43-14.1\/","token":"43\/1\/43-14.1","metadata":false},{"id":363660,"structure_id":51889,"section_number":"43-15","catch_line":"Inaccuracies in memorandum or description not affecting lien","url":"\/43-15\/","token":"43\/1\/43-15","metadata":false},{"id":363661,"structure_id":51889,"section_number":"43-16","catch_line":"What owner may do when contractor fails or refuses to complete building, etc","url":"\/43-16\/","token":"43\/1\/43-16","metadata":false},{"id":363663,"structure_id":51889,"section_number":"43-17","catch_line":"Limitation on suit to enforce lien","url":"\/43-17\/","token":"43\/1\/43-17","metadata":false},{"id":363662,"structure_id":51889,"section_number":"43-17.1","catch_line":"Hearing on validity of lien","url":"\/43-17.1\/","token":"43\/1\/43-17.1","metadata":false},{"id":363664,"structure_id":51889,"section_number":"43-18","catch_line":"Lien of general contractor to inure to benefit of subcontractor","url":"\/43-18\/","token":"43\/1\/43-18","metadata":false},{"id":363665,"structure_id":51889,"section_number":"43-19","catch_line":"Validity and priority of lien not affected by assignments","url":"\/43-19\/","token":"43\/1\/43-19","metadata":false},{"id":363666,"structure_id":51889,"section_number":"43-2","catch_line":"Structures, materials, etc., deemed permanently annexed to freehold","url":"\/43-2\/","token":"43\/1\/43-2","metadata":false},{"id":363667,"structure_id":51889,"section_number":"43-20","catch_line":"Extent of lien where owner has less than fee in land","url":"\/43-20\/","token":"43\/1\/43-20","metadata":false},{"id":363668,"structure_id":51889,"section_number":"43-21","catch_line":"Priorities between mechanics' and other liens","url":"\/43-21\/","token":"43\/1\/43-21","metadata":false},{"id":363669,"structure_id":51889,"section_number":"43-22","catch_line":"How liens enforced","url":"\/43-22\/","token":"43\/1\/43-22","metadata":false},{"id":363672,"structure_id":51889,"section_number":"43-23","catch_line":"Priority among liens perfected under this chapter","url":"\/43-23\/","token":"43\/1\/43-23","metadata":false},{"id":363670,"structure_id":51889,"section_number":"43-23.1","catch_line":"Forfeiture of lien","url":"\/43-23.1\/","token":"43\/1\/43-23.1","metadata":false},{"id":363671,"structure_id":51889,"section_number":"43-23.2","catch_line":"Remedies cumulative","url":"\/43-23.2\/","token":"43\/1\/43-23.2","metadata":false},{"id":363680,"structure_id":51889,"section_number":"43-3","catch_line":"Lien for work done and materials furnished; waiver of right to file or enforce lien","url":"\/43-3\/","token":"43\/1\/43-3","metadata":false},{"id":363694,"structure_id":51889,"section_number":"43-4","catch_line":"Perfection of lien by general contractor; recordation and notice","url":"\/43-4\/","token":"43\/1\/43-4","metadata":false},{"id":363692,"structure_id":51889,"section_number":"43-4.01","catch_line":"Posting of building permit; identification of mechanics' lien agent in building permit; notice to mechanics' lien agent; effect of notice","url":"\/43-4.01\/","token":"43\/1\/43-4.01","metadata":false},{"id":363693,"structure_id":51889,"section_number":"43-4.1","catch_line":"Liens to be recorded in deed books and indexed in general index of deeds","url":"\/43-4.1\/","token":"43\/1\/43-4.1","metadata":false},{"id":363700,"structure_id":51889,"section_number":"43-5","catch_line":"Sufficiency of memorandum and affidavit required by \u00a7 43-4","url":"\/43-5\/","token":"43\/1\/43-5","metadata":false},{"id":363701,"structure_id":51889,"section_number":"43-6","catch_line":"Repealed","url":"\/43-6\/","token":"43\/1\/43-6","metadata":false},{"id":363711,"structure_id":51889,"section_number":"43-7","catch_line":"Perfection of lien by subcontractor; extent of lien; affirmative defense; provisions relating to time-share estates","url":"\/43-7\/","token":"43\/1\/43-7","metadata":false},{"id":363714,"structure_id":51889,"section_number":"43-8","catch_line":"Sufficiency of memorandum, affidavit and notice required by \u00a7 43-7","url":"\/43-8\/","token":"43\/1\/43-8","metadata":false},{"id":363715,"structure_id":51889,"section_number":"43-9","catch_line":"Perfection of lien by person performing labor or furnishing materials for a subcontractor; extent of lien","url":"\/43-9\/","token":"43\/1\/43-9","metadata":false}],"previous_section":{"id":363693,"structure_id":51889,"section_number":"43-4.1","catch_line":"Liens to be recorded in deed books and indexed in general index of deeds","url":"\/43-4.1\/","token":"43\/1\/43-4.1","metadata":false},"next_section":{"id":363701,"structure_id":51889,"section_number":"43-6","catch_line":"Repealed","url":"\/43-6\/","token":"43\/1\/43-6","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/43-5\/","history_text":"<p>The record of this law\u2019s original creation isn\u2019t available online. It has been modified 4 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1968, chapter 568; in 2007, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?071+ful+CHAP0504\">504<\/a>; in 2013, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?131+ful+CHAP0293\">293<\/a>; in 2019, chapter <a href=\"https:\/\/legacylis.virginia.gov\/cgi-bin\/legp604.exe?191+ful+CHAP0243\">243<\/a>.<\/p>","references":[{"id":363660,"section_number":"43-15","catch_line":"Inaccuracies in memorandum or description not affecting lien","order_by":null,"url":"\/43-15\/"},{"id":363663,"section_number":"43-17","catch_line":"Limitation on suit to enforce lien","order_by":null,"url":"\/43-17\/"}],"refers_to":[{"id":363694,"section_number":"43-4","catch_line":"Perfection of lien by general contractor; recordation and notice","order_by":null,"url":"\/43-4\/"}],"permalink":{"id":1448379,"object_type":"law","relational_id":363700,"identifier":"43-5","token":"43\/1\/43-5","url":"\/43-5\/","edition_id":2,"permalink":0,"preferred":1},"url":"\/43-5\/","token":"43\/1\/43-5","dublin_core":{"Title":"Sufficiency of memorandum and affidavit required by \u00a7 43-4","Type":"Text","Format":"text\/html","Identifier":"\u00a7 43-5","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t<section><p>The <span class=\"dictionary\">memorandum<\/span> and <span class=\"dictionary\">affidavit<\/span> required by \u00a7&nbsp;<a class=\"law\" title=\"Perfection of lien by general contractor; recordation and notice\" href=\"\/43-4\/\">43-4<\/a> shall be sufficient if substantially in form and effect as follows:<br \/><br \/>\t\t<span class=\"dictionary\">Memorandum<\/span> for Mechanic&#8217;s <span class=\"dictionary\">Lien<\/span> Claimed by General Contractor.<br \/><br \/>\t\tName of owner: ___________________________________________________________________________<br \/><br \/>\t\tAddress of owner: ___________________________________________________________________________<br \/><br \/>\t\tName of claimant: ___________________________________________________________________________<br \/><br \/>\t\tAddress of claimant: ___________________________________________________________________________<br \/><br \/>\t\tContractor license or certificate number of claimant<br \/><br \/>\t\t(if applicable): ___________________________________________________________________________<br \/><br \/>\t\tIssuance date of license or certificate<br \/><br \/>\t\t(if applicable): ___________________________________________________________________________<br \/><br \/>\t\tExpiration date of license or certificate<br \/><br \/>\t\t(if applicable): ___________________________________________________________________________<br \/><br \/>\t\tIf no contractor license or certificate number is included, the claimant certifies that such a valid license or certificate is not  required by <span class=\"dictionary\">law<\/span> for the work done for which the benefit of a <span class=\"dictionary\">lien<\/span> is claimed.<\/p><\/section>\n\t\t\t\t\t\t<section id=\"1\"><p><span class=\"prefix-number\">1.<\/span> Type of <span class=\"dictionary\">materials<\/span> or services furnished: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________\n\t\t\t___________________________________________________________________________<br \/><br \/>\t\t\t___________________________________________________________________________ <a id=\"paragraph-1354971\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/43-5\/#1\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"2\"><p><span class=\"prefix-number\">2.<\/span> Amount claimed:  $ ___________________________________________________________________________\n\t\t\tIf any part of the Amount claimed is not due as of the date of this mechanic&#8217;s <span class=\"dictionary\">lien<\/span>, identify the date or event upon which it will be due and the sum(s) to which the due date(s) or event(s) apply: ___________________________________________________________________________ <a id=\"paragraph-1354972\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/43-5\/#2\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"3\"><p><span class=\"prefix-number\">3.<\/span> Type of structure on which work done or <span class=\"dictionary\">materials<\/span> furnished: ___________________________________________________________________________\n\t\t\t___________________________________________________________________________ <a id=\"paragraph-1354973\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/43-5\/#3\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"4\"><p><span class=\"prefix-number\">4.<\/span> <span class=\"dictionary\">Brief<\/span> description and location of real property:\n\t\t\t___________________________________________________________________________ <a id=\"paragraph-1354974\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/43-5\/#4\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t<section id=\"5\"><p><span class=\"prefix-number\">5.<\/span> Date from which interest on the above amount is claimed:\n\t\t\tDate: _______________________<br \/><br \/>\t\t\tIt is the <span class=\"dictionary\">intent<\/span> of the claimant to claim the benefit of a <span class=\"dictionary\">lien<\/span>.<br \/><br \/>\t\t\tThe undersigned hereby certifies that he has mailed a copy of this <span class=\"dictionary\">memorandum<\/span> of <span class=\"dictionary\">lien<\/span> to the owner of the property at the owner&#8217;s last known address: &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;. (address), on &#8230;&#8230;..   (date of mailing).<br \/><br \/>\t\t\t___________________________________________________________________________  (Name of claimant).<br \/><br \/>\t\t\t<span class=\"dictionary\">Affidavit<\/span>.<br \/><br \/>\t\t\tState of Virginia,<br \/><br \/>\t\t\tCounty (or city) of &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;,  to wit:<br \/><br \/>\t\t\tI, _______________________  (notary or other officer) for the county (or city) aforesaid, do certify that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.  claimant, or &#8230;&#8230;&#8230;&#8230;&#8230;., agent for claimant, this day made <span class=\"dictionary\">oath<\/span> before me in my county (or city) aforesaid that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; (the owner) is justly indebted to claimant in the sum of &#8230;&#8230;&#8230;&#8230;.. dollars, for the consideration stated in the foregoing <span class=\"dictionary\">memorandum<\/span>, and that the same is payable as therein stated.<br \/><br \/>\t\t\tGiven under my hand this the &#8230;&#8230;.. day of &#8230;&#8230;&#8230;&#8230;&#8230;.., 20&#8230;.<br \/><br \/>\t\t\t___________________________________________________________________________ (Notary Public or <span class=\"dictionary\">Magistrate<\/span>, et cetera.) <a id=\"paragraph-1354975\" class=\"section-permalink\" href=\"https:\/\/vacode.org\/43-5\/#5\"><i class=\"fa fa-link\"><\/i><\/a><\/p><\/section>","plain_text":"                                 CODE OF VIRGINIA\n\nSUFFICIENCY OF MEMORANDUM AND AFFIDAVIT REQUIRED BY \u00a7 43-4 (\u00a7 43-5)\n\nThe memorandum and affidavit required by \u00a7 43-4 shall be sufficient if\nsubstantially in form and effect as follows:\t\tMemorandum for Mechanic&#8217;s\nLien Claimed by General Contractor.\t\tName of owner:\n___________________________________________________________________________\t\tAdd\nress of owner:\n___________________________________________________________________________\t\tNam\ne of claimant:\n___________________________________________________________________________\t\tAdd\nress of claimant:\n___________________________________________________________________________\t\tCon\ntractor license or certificate number of claimant\t\t(if applicable):\n___________________________________________________________________________\t\tIss\nuance date of license or certificate\t\t(if applicable):\n___________________________________________________________________________\t\tExp\niration date of license or certificate\t\t(if applicable):\n___________________________________________________________________________\t\tIf\nno contractor license or certificate number is included, the claimant certifies\nthat such a valid license or certificate is not  required by law for the work\ndone for which the benefit of a lien is claimed.\n\n1. Type of materials or services furnished:\n___________________________________________________________________________\n___________________________________________________________________________\n___________________________________________________________________________\n\t\t\t___________________________________________________________________________\t\t\n\t___________________________________________________________________________\n\n2. Amount claimed:  $\n___________________________________________________________________________\n\t\t\tIf any part of the Amount claimed is not due as of the date of this\nmechanic&#8217;s lien, identify the date or event upon which it will be due and\nthe sum(s) to which the due date(s) or event(s) apply:\n___________________________________________________________________________\n\n3. Type of structure on which work done or materials furnished:\n___________________________________________________________________________\n\t\t\t___________________________________________________________________________\n\n4. Brief description and location of real property:\n\t\t\t___________________________________________________________________________\n\n5. Date from which interest on the above amount is claimed:\n\t\t\tDate: _______________________\t\t\tIt is the intent of the claimant to claim the\nbenefit of a lien.\t\t\tThe undersigned hereby certifies that he has mailed a copy\nof this memorandum of lien to the owner of the property at the owner&#8217;s\nlast known address:\n&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.\n(address), on &#8230;&#8230;..   (date of\nmailing).\t\t\t____________________________________________________________________\n_______  (Name of claimant).\t\t\tAffidavit.\t\t\tState of Virginia,\t\t\tCounty (or\ncity) of &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;,  to wit:\t\t\tI,\n_______________________  (notary or other officer) for the county (or city)\naforesaid, do certify that &#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;. \nclaimant, or &#8230;&#8230;&#8230;&#8230;&#8230;., agent for claimant, this day\nmade oath before me in my county (or city) aforesaid that\n&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; (the owner) is justly indebted\nto claimant in the sum of &#8230;&#8230;&#8230;&#8230;.. dollars, for the\nconsideration stated in the foregoing memorandum, and that the same is payable\nas therein stated.\t\t\tGiven under my hand this the &#8230;&#8230;.. day of\n&#8230;&#8230;&#8230;&#8230;&#8230;..,\n20&#8230;.\t\t\t___________________________________________________________________\n________ (Notary Public or Magistrate, et cetera.)\n\nHISTORY: Code 1919, \u00a7 6427; 1940, p. 402; 1968, c. 568; 2007, c. 504; 2013, c.\n293; 2019, c. 243.","edition":{"id":2,"name":"2026","slug":"2026","date_created":"2026-07-16 18:40:23","date_modified":"2026-08-02 15:14:36","current":1,"order_by":2,"last_import":"2026-08-02 12:37:30"}}