If the lien relates to a homestead, the affidavit must contain the notice preceding the title of this form. The language of the notice is prescribed by Tex. Prop. Code § 53.254(f) and must appear at the top of the page in a minimum of ten-point bold-faced type or equivalent.
Notice: This is not a lien. This is only an affidavit claiming a lien.
Affidavit Claiming Mechanic’s and Materialman’s Lien
[For Use If Original Contract Entered Into on or after January 1, 2022]
Affiant, [name of affiant], on oath swears that the following statements are true and are within the personal knowledge of Affiant:
My name is [name of affiant]. I am the [claimant/[title] of [name of claimant]] (“Claimant”). This affidavit is made to perfect a mechanic’s and materialman’s lien against the real property described below:
1.Claimant has an unpaid claim in the amount of $[amount] (“Claim Amount”) for [labor/materials/labor and materials] furnished on the construction of improvements generally known as the [specify] construction project. The Claim Amount is, within my personal knowledge, just and true, the same is due and unpaid, and all just and lawful offsets, payments, and credits have been allowed. The Claim Amount is for [labor/materials/labor and materials] furnished and described below, on which a systematic record has been kept.
2.The name and last known address of the owner or reputed owner (“Owner”) of the real property and improvements on which this claim is made are [name and address].
3.The Claim Amount represents the unpaid contract price due Claimant, or, in the alternative, is the reasonable value of the unpaid portion of Claimant’s [labor/materials/labor and materials] furnished, which are described below.
4.Claimant’s [labor/materials/labor and materials] furnished for construction of improvements on the real property described below [is/are] generally described as [describe, e.g., specially fabricated and installed plumbing, heating, ventilating, and air-conditioning duct work, equipment, and allied systems]. Payment of the Claim Amount is requested for work performed or materials furnished during each of the following months: [specify months].
5.Claimant furnished the above-described [labor/materials/labor and materials] under a [subcontract/contract/purchase order] with [name of customer], whose last known address is [address].
6.The name and last known address of the original contractor on the above-referenced project are [name and address].
7.The legal description of the real property improved by Claimant’s above-described [labor/materials/labor and materials] is [legal description]. That real property and improvements on it are sought to be charged with Claimant’s lien.
8.Claimant claims a mechanic’s and materialman’s lien on the above-described real property and improvements thereon to secure payment of its Claim Amount in accordance with the Texas Property Code.
9.Claimant’s physical address is [address]. Claimant’s mailing address is [address].
10.Claimant’s notice[s] of mechanic’s lien [was/were] sent to Owner by United States certified mail, return receipt requested, on the following date[s]: [specify date[s]].
11.In compliance with the Texas Property Code, Claimant is sending one copy of this affidavit to Owner at its last known address and also one copy to the above-referenced original contractor at its last known address.
[Name of affiant]
SUBSCRIBED AND SWORN TO before me on __________________ by [name of affiant].
Notary Public, State of Texas