                                 CODE OF VIRGINIA

SUFFICIENCY OF MEMORANDUM, AFFIDAVIT AND NOTICE REQUIRED BY § 43-9 (§ 43-10)

The memorandum, affidavit and notice required by § 43-9 shall be sufficient if
substantially in form and effect as follows:		Memorandum for Mechanic&#8217;s
Lien Claimed by Sub-subcontractor.		Name of owner:
___________________________________________________________________________		Add
ress of owner:
___________________________________________________________________________		Nam
e of general contractor (if any) and
subcontractor:		________________________________________________________________
___________		Name of claimant: 
___________________________________________________________________________		Add
ress of claimant: 
___________________________________________________________________________		Con
tractor license or certificate number of claimant		(if applicable):
___________________________________________________________________________		Iss
uance date of license or certificate		(if applicable):
___________________________________________________________________________		Exp
iration 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: $
___________________________________________________________________________
			If 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:
___________________________________________________________________________

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 &#8230;&#8230;&#8230;&#8230;&#8230;. day
of &#8230;&#8230;&#8230;&#8230;&#8230;,
20&#8230;.			________________________________________ (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
&#8230;&#8230;&#8230;&#8230;.			&#8230;&#8230;&#8230;&#8230;&#8230;.. dollars ($
______________) with interest thereon from the &#8230;. day of &#8230;&#8230;.,
20&#8230;, 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&#8217;s lien for the same.			Given under my hand this the
&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; day of
&#8230;&#8230;&#8230;&#8230;&#8230;,
20&#8230;&#8230;.			__________________________________________________
(Sub-subcontractor).

HISTORY: Code 1919, § 6429; 1968, c. 568; 1984, c. 647; 2007, c. 504; 2013, c.
293; 2019, c. 243.