Fillable MECHANICS OR STORAGE LIEN APPLICATION (Virginia Department of Motor Vehicles)

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MECHANICS OR STORAGE LIEN APPLICATION (Virginia Department of Motor Vehicles)

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VSA 41 (07/25/2017)
This is to request that DMV furnish information from its files on the above-described vehicle in accordance with Va. Code §§46.2-644.01, 46.2-644.02 and 46.2-644.03. I understand that
it is unlawful to use information provided by DMV for any purpose other than the one stated. I certify that the information I have requested with this form will be used only for the stated
purpose.
I further certify and affirm that all information presented in this form is true and correct, that any documents I have presented to DMV are genuine, and that the information included in all
supporting documentation is true and correct. I make this certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or
representation on this form is a criminal violation.
SIGNATUREAUTHORIZED MECHANIC OR STORAGE LIENHOLDER NAME (print)
AUTHORIZED TITLE SERVICE REPRESENTATIVE NAME (print) SIGNATURE
TELEPHONE NUMBER
TITLING SERVICE NAME
STREET ADDRESS CITY ZIP CODE
STATE
FEIN OR SOCIAL SECURITY NUMBER USE AGREEMENT NUMBER (if applicable) ACCESS CODE (if applicable)
(Required by the State Comptroller for
debt off-set purposes per Va Code
§§2.2-803, 2.2-4807, et.al)
DATE(mm/dd/yyyy)
TITLING SERVICE INFORMATION
Complete the information below only if a titling service is submitting this request on behalf of the lienholder.
DATE(mm/dd/yyyy)
Note: The NADA trade-in value is used to determine the Mechanics and Storage Lien Applicant Requirements as outlined on page 2.
NADA Trade in Value: (Check applicable box.)
$3,000 or less and $3,001 to $12,500
$12,501 to $25,000 (Must petition General District Court) $25,001 or more (Must petition the Circuit Court)
DMV USE ONLY
VEHICLE RECORD REQUEST
YEAR MODEL BODY TYPE
VEHICLE IDENTIFICATION NUMBERSTATE
COLOR
LICENSE PLATE NUMBER
MAKE
VEHICLE INFORMATION
TELEPHONE NUMBER
COMPANY TELEPHONE NUMBER
NAME OF COMPANY HOLDING VEHICLE
STREET ADDRESS CITY ZIP CODE
FEIN OR SOCIAL SECURITY NUMBER ACCESS CODE (if applicable)USE AGREEMENT NUMBER (if applicable)
STATE
MECHANIC OR STORAGE FACILITY RECORDING LIEN
(Required by the State Comptroller for
debt off-set purposes per Va Code
§§2.2-803, 2.2-4807, et.al)
STREET ADDRESS WHERE VEHICLE IS HELD (if different from above)
CITY ZIP CODE
STATE
Check applicable box and attach a copy of the invoice (both checkboxes may apply, see pg. 2) Was this vehicle towed at the direction of law enforcement?
$
$
Total $
I have a Storage Lien under Va Code § 46.2-644.01 in the amount of
I have a Mechanic's Lien under Va Code § 46.2-644.02 in the amount of
PURPOSE OF REQUEST
If yes, enter date towed (mm/dd/yyyy):
YES NO
MECHANICS OR STORAGE LIEN
APPLICATION
PURPOSE: Use this application to request a mechanic's or storage lien, as provided in Va Code §§46.2-644.01, 46.2-644.02 and
46.2-644.03.
INSTRUCTIONS: Complete this application using the requirements provided on page 2 of this form.
DATE YOU TOOK POSSESSION OF VEHICLE (mm/dd/yyyy):
Vehicle Value was determined by:
Vehicles that meet any of the following criteria must be processed by DMV Headquarters Titling Work Center
• Have no NADA value or transcript • NADA trade value is $25,001 or more • Vehicle age is 5 years or newer
MSL Transcript (attached) NADA Online Trade-In Value Web Page (printout attached)
Independent Appraisal - NADA Trade-in Value is $3000 or less; No record of owner or lienholder on DMV record; Vehicle is 6 years or older
DMV recognized the NADA Official Used Car Guide trade in value: $
( )
( )
( )
VSA 41 (07/25/2017)
Page 2
For the purposes of a mechanic's and/or storage lien, the following definitions apply:
Trade in Value -- The vehicle value as determined by the NADA OFFICIAL USED CAR GUIDE.
Public Place -- A premises or agency open to the public and owned by the Commonwealth of Virginia, or a political subdivision thereof, or an agency of either,
that is open to the general public Virginia county, city, or any other Virginia political subdivision, where postings are permitted.
Independent Appraiser -- Someone who provides the MSL applicant with an estimated trade-in value appraisal and does not gain income or have personal or
business related interest in the ownership or sale of the vehicle.
DEFINITIONS
MECHANIC OR STORAGE LIEN APPLICANT REQUIREMENTS
Note: If the MSL transcript indicates the vehicle owner is active duty military, a court order from a court in the MSL applicant's jurisdiction, regardless of the value
of the vehicle, must be submitted with application at the time of titling. A copy of original repair bill/invoice is required when applying for an MSL transcript.
NADA Trade-In Value Instructions
$12,500 or less
• Apply for MSL vehicle transcript at a Customer Service Center or via Extranet (for users with Use Agreement), and
• Notify all vehicle owner(s) and lienholder(s) by certified or registered mail (return receipt requested) of the intent to sell the
vehicle at least 10 days prior to the auction, and
◦ If the owner of the property is a nonresident or owner’s address is unknown (no record found), a notice is required to
be served by posting a copy in three of any of the following places in any combination: (i) post notice in one or more
public places in the county or city where the property is located; (ii) one or more websites operated by the
Commonwealth, the county or city where the property is located, or a political subdivision of either; or (iii) one or more
newspapers of general circulation in the county or city where the property is located, either in print or on their websites.
• MSL applicant must hold the vehicle in their possession for a minimum of 30 days, and
• Advertise the date, time and place of auction along with the terms of the auction in at least one public place at least 10 days prior
to the auction date, and
• Once sold, provide purchaser documentary evidence of compliance with all MSL requirements for titling, as listed on VSA 41.
Exception
$3,000 or less and ALL of
the following applies:
• NADA Trade-In Value is
$3,000 or less
• No record of owner or
lienholder exists on DMV's
record
• Vehicle is 6 years or older
than current model year
• Vehicle held in applicant's
custody for 30 or more
days
• Apply for MSL vehicle transcript at a Customer Service Center or via Extranet (for users with Use Agreement).
• Show proof of vehicle was in MSL applicant possession a minimum of 30 days
• Submit application and required documents for title or nonrepairable certificate or sell vehicle
IMPORTANT: If an owner or lienholder exists on the vehicle record, this exception does NOT apply. Owner and/or lienholder must
be notified and auction held according to MSL guidelines.
$12,501 To $25,000
• Apply for MSL vehicle transcript at a Customer Service Center or via Extranet (for users with Use Agreement).
• Notify all vehicle owner(s) and lienholder(s) by certified or registered mail (return receipt requested) of the intent to sell the
vehicle at least 10 days prior to the auction.
◦ If the owner of the property is a nonresident or owner’s address is unknown (no record found), a notice is required to
be served by posting a copy in three of any of the following places in any combination: (i) post notice in one or more
public places in the county or city where the property is located; (ii) one or more websites operated by the
Commonwealth, the county or city where the property is located, or a political subdivision of either; or (iii) one or more
newspapers of general circulation in the county or city where the property is located, either in print or on their websites.
• Hold the vehicle in MSL applicant possession a minimum of 30 days.
• Advertise the date, time and place of auction along with the terms of the auction in at least one public place at least 10 days prior
to the auction date.
• Petition the General District Court in the city or county where the vehicle is located to order the vehicle sale, and
• Be granted the petition by the court, and
• Hold auction through the sheriff of the jurisdiction once the sale is ordered, and
• Request sheriff complete an affidavit of compliance (3rd page of the VSA 41) acknowledging vehicle was auctioned/sold in
compliance with the court order.
Exceeds $25,000
• Apply for MSL vehicle transcript at a Customer Service Center or via Extranet (for users with Use Agreement).
• Notify all vehicle owner(s) and lienholder(s) by certified or registered mail (return receipt requested) of the intent to sell the
vehicle at least 10 days prior to the auction.
◦ If the owner of the property is a nonresident or owner’s address is unknown (no record found), a notice is required to
be served by posting a copy in three of any of the following places in any combination: (i) post notice in one or more
public places in the county or city where the property is located; (ii) one or more websites operated by the
Commonwealth, the county or city where the property is located, or a political subdivision of either; or (iii) one or more
newspapers of general circulation in the county or city where the property is located, either in print or on their websites.
• Hold the vehicle in MSL applicant possession a minimum of 30 days.
• Advertise the date, time and place of auction along with the terms of the auction in at least one public place at least 10 days prior
to the auction date.
• Petition the Circuit Court in the city or county where the vehicle is located, to order the sale of the vehicle, and be granted the
petition by the court and
• Hold auction through the sheriff of the jurisdiction once the sale is ordered, and
• Request the sheriff to complete an affidavit of compliance (3rd page of VSA 41) acknowledging the vehicle was auctioned/sold in
compliance with court order.
VSA 41 (07/25/2017)
REGISTRATION NUMBER MY COMMISSION EXPIRES (mm/dd/yyyy)
NOTARY PUBLIC NAME NOTARY PUBLIC SIGNATURE
MECHANICS OR STORAGE LIEN
APPLICATION
AFFIDAVIT OF COMPLIANCE WITH VA CODE §§ 46.2-644.01 THROUGH 46.2-644.03 AND 8.01-419.1
PURPOSE: This affidavit must be completed by the mechanic or storage lienholder and must be submitted by the purchaser with the
required documents, fees and taxes.
INSTRUCTIONS: Print or type. Follow the instructions on page 2.
NOTARIZATION (must be completed by notary public)
State/Commonwealth of ______________________, city or county of _____________________________
subscribed and sworn to before me on this ____________ day of ________________________________
(MONTH) (YEAR)
by___________________________________________________ in the city or county and state aforesaid.
NOTARY PUBLIC SEAL
Page 3
PURCHASER INFORMATION
PURCHASER NAME VEHICLE SALE DATE (mm/dd/yyyy)
VEHICLE SALE PRICE
$
VEHICLE YEAR VEHICLE MAKE VEHICLE IDENTIFICATION NUMBER (VIN)
VEHICLE QUALIFICATION
Check this box if the vehicle qualifies to be titled under Va Code §46.2-644.03.
Check this box if the vehicle qualifies for a non-repairable certificate under Va Code §46.2-644.03.
COMPLIANCE INFORMATION
As the Mechanic or Storage Lienholder, I have: (Check all applicable boxes)
applied to DMV for vehicle owner and lienholder information as a result of a Mechanic's or Storage Lien that occurred in Virginia.
held the vehicle in MSL applicant possession for a minimum of 30 days.
made notice of intent to sell the vehicle under the procedure prescribed by Va Code §§ 46.2-644.01 through 46.2-644.03.
arranged for the vehicle to be sold under the procedure prescribed by Va Code §§ 46.2-644.01 through 46.2-644.03.
CERTIFICATION / AFFIDAVIT
(Must be signed and dated by the mechanic or storage lienholder in the presence of a notary public.)
I certify that I have complied with the requirements of Va Code §§ 46.2-644.01 through 46.2-644.03 and 8.01-419.1.
I further certify and affirm that all information presented in this form is true and correct; that any documents I have presented to DMV are genuine, and that
the information included in all supporting documentation is true and correct. I make this certification and affirmation under penalty of perjury and I
understand that knowingly making a false statement or representation on this form is a criminal violation.
MECHANIC OR STORAGE LIENHOLDER NAME (print)
MECHANIC OR STORAGE LIENHOLDER SIGNATURE
DATE (mm/dd/yyyy)
SHERIFF'S AFFIDAVIT
This vehicle was sold in our locality by a public auction in compliance with a court order (court order attached)
JURISDICTION DATE OF SALE (mm/dd/yyyy) BADGE NUMBER
SHERIFF NAME (print)
SHERIFF SIGNATURE
VSA 41 (07/25/2017)
Page 4
MECHANICS OR STORAGE LIEN APPLICATION
VEHICLE DISPOSITION
Check the applicable box to indicate what you plan to do with the vehicle
Sell Vehicle Purchase/Title vehicle in my name Vehicle is non-repairable
All applicants must present a completed VSA 17A or VSA 57, VSA 41, the DMV Record Search Results and all required documentation according to the vehicle's
value. Check documents presented:
Completed VSA 17A Completed VSA 57 Completed VSA 41 DMV Record Search Results
DMV USE ONLY - DOCUMENTS REQUIRED TO TITLE
Section NADA Trade-In Value Documents Required to Title
1
$12,500 or less
MSL Transcript issued by DMV
(Vehicle is 6 model years or
older than the current
NADA Trade-In Value screen print if found online at NADA website
model year)
VSA 41, VSA 17A or VSA 17B with fees, or VSA 57 (no fee)
Bill of sale from mechanic/storage lienholder holding auction (when purchased by 3rd party) and SUT 1A for vehicles 5
years old or less
Copy of posted public auction notice and location of the auction
Copy of newspaper and/or web posting (if applicable)
Copy of original repair bill/invoice or storage bill/invoice
Proof MSL applicant held vehicle in continuous custody for at least 30 days
Copy of actual letter sent, and certified/registered mail return receipt (if delivered), or certified/registered letter
(unopened) with return receipt attached (not delivered)
Section 1 Exception
$3,000 or less MSL Transcript showing "No Record Found" issued by DMV
No Vehicle Record Found VSA 41
VSA 17A or VSA 17B with fee, or VSA 57 (no fee required)
Bill of sale from mechanic/storage lienholder holding auction (when purchased by 3rd party) and SUT 1A for vehicles 5
years old or less
Proof MSL applicant held vehicle in continuous custody for at least 30 days
2 $12,501 To $25,000
MSL Transcript issued by DMV
(Vehicle is 6 model years
or older than the current
NADA Trade-In Value screen print if found online at NADA website
model year)
VSA 41, VSA 17A or VSA 17B with fees, or VSA 57 (no fee)
Bill of sale from mechanic/storage lienholder holding auction (when purchased by 3rd party) and SUT 1A for vehicles 5
years old or less
Copy of posted public auction notice and location of the auction
Copy of newspaper and/or web posting (if applicable)
Copy of original repair bill/invoice or storage bill/invoice
Proof MSL applicant held vehicle in continuous custody for at least 30 days
Copy of actual letter sent, and certified/registered mail return receipt (if delivered), or certified/registered letter
(unopened) with return receipt attached (not delivered)
The court order granted by General District Court
Affidavit from sheriff stating that the vehicle was sold in compliance with the courts order (VSA 41, page 3)
3 Exceeds $25,000 MSL Transcript
(regardless of model year) NADA Trade-In Value screen print if found online at NADA website
VSA 41, VSA 17A or VSA 17B with fees OR VSA 57 (no fee required)
Bill of sale from mechanic or storage lienholder who held auction (when purchased by 3rd party) and SUT 1A for
vehicles 5 years old or less
Copy of posted public auction notice and location of the auction
Copy of newspaper and/or web posting (if applicable)
Copy of original repair bill/invoice or storage bill/invoice
Proof of vehicle was in his/her continuous custody for at least 30 days.
Copy of actual letter sent, and certified/registered mail return receipt (if delivered), or certified/registered letter
(unopened) with return receipt attached (not delivered)
The court order granted by Circuit Court
Affidavit from sheriff stating that the vehicle was sold in compliance with the courts order (VSA 41, page 3)
4
No NADA Trade-In
Value Found By DMV
Mail MSL title or nonrepairable application and all documents to support the vehicle’s value directly to the Titling Work
Center, or drop at a CSC to be scanned to Titling Work Center.
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MECHANICS OR STORAGE LIEN APPLICATION (Virginia Department of Motor Vehicles)

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Completed 29 July 2020

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