Mechanic'S Lien - Residential Real Property Form - St.louis County, Missouri
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1
2IN THE 21st JUDICIAL CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
Division:
Case Number:
Lien Claimant:
Claimant’s Address:
City, State, Zip:
Telephone Number:
vs.
Owner/Lessee/Licensee:
Owner/Lessee/Licensee’s Address:
City, State, Zip:
Telephone Number:
(Date File Stamp)
Mechanic’s Lien – Residential Real Property
As a lien claimant and in accordance with Chapter 429 RSMo, I file the statement of account below. The statement
details amounts due for work performed and/or materials furnished under a contract with
_____________________________________________________________ (name and address of owner or contractor)
for real estate located in ___________________________________ (County/City of St. Louis), Missouri and described
as follows:
(Provide legal description of real estate. Attach additional pages, if necessary.)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
The property described is subject to the following encumbrance(s) that is/are recorded as follows:
(List the type of encumbrance and where it is recorded. Attach additional pages, if necessary.)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
The last work performed and/or materials or services furnished for the property described above was on
________________________ (date). A demand for the amount due the lien claimant was made within six (6) months
prior to filing this lien.
The statement of account is filed in order that it may constitute a lien on the property described above. The
statement is a just and true account of the demands due claimant after all appropriate credits have been given.
OSCA (7-10) GN160
1 of 2
429.005 - 429.360 RSMo
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