MVD - 10058

REV. 12/02
STATE OF NEW MEXICO - MOTOR VEHICLE DIVISION

NOTICE OF MECHANIC'S OR LANDOWNER'S LIEN

A separate notice must be completed and sent to the registered owner, lienholder (if applicable) and any other
interested party when the account becomes due and payable. If the licensing jurisdiction where the vehicle was last
registered returns a "NO RECORD" verification, lien claimant must still complete this notice.

TO: q Registered Owner q Lienholder q Other :

Name:

Address:

City, State, Zip Code:

TAKE NOTICE THAT THE UNDERSIGNED CLAIMS A LIEN ON THE VEHICLE DESCRIBED BELOW:
Year Make Model Type State Registered

Engine Number (If Applicable) Vehicle Identification Number License Plate Number

q FOR: Landowner's storage services of $________________ for __________ days at $ __________ per day.

q FOR: Mechanic's towing, labor, parts & storage services in the amount of $ ________________________ ,
itemized as follows. Attach a separate sheet if necessary.
$
$
$
$
WARNING: Landowner's and mechanic's storage fees (in addition to itemized charges) will continue to accumulate at a
rate of $ _________________ per day until debt is satisfied or vehicle is sold at public auction, whichever comes first.
(You may not charge more than 50 per day for storage unless you are licensed as a vehicle storage yard.)

The services described above were provided by Lien Claimant from about _______________ , 20 _____
to _______________ , 20 _____ , first and last dates.
Lien Claimant

Address

City, State, Zip Code

Interested parties are herewith notified that if the above sum is not paid within ten (10) days from receipt of this notice,
the undersigned will proceed to advertise the vehicle for sale and sell same as provided by law to satisfy the debt.

I, (please print or type name)

hereby certify that all information given in this notice is true and correct to the best of my knowledge.

X
Signature of Lien Claimant or Authorized Agent (Power of Attorney may be required for Agent) Date
NOTE: Lien Claimant must retain a copy of this notice to submit to the Motor Vehicle Division along with Affidavit of Resale (Form 10059) when applicable.