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IN THE MAGISTRATE COURT OF CAMDEN COUNTY STATE OF GEORGIA * * Plaintiff/Lien Claimant, * * v * Civil Action No. * * Motor Vehicle, * * * Vehicle Identification No. * AFFIDAVIT FOR MECHANICS’ LIEN Personally appeared who, on oath, says that he is a mechanic, that as such mechanic he was recently employed by of said county, to work and labor and to furnish material in repairing: at the following rate of and that he, did said work and labor and furnished said material on the said property according to the contract amount of administrative fees of and court costs of for an earned total sum of That said amount is due and unpaid and he, has demanded payment of said debtor after it became due and it was refused. That the name and address of the owner and all lienholders having an interest in said vehicle are as follows: Name Address (Owner, Lienholder, Etc.) Name Address (Owner, Lienholder, Etc.) Name Address (Owner, Lienholder, Etc.) WHEREFORE, affiant, being in possession of or having filed his claim of lien as required by law on said property now comes, within one year after said debt became due, and makes this affidavit for the purpose of foreclosing his lien upon said property and prays that execution issue for said sum with legal interest and all costs of this suit. Sworn and subscribed before me this day of Signature of Plaintiff or Agent Clerk/Deputy Clerk/Notary Public Phone: NOTICE In accordance with O.C.G.A.§ 40-3-54, you are hereby notified that has filed a petition to foreclose on a mechanics’ lien in which you are listed as either the owner, lessor, lessee, security interest holder or lienholder. You have five days from receipt of this notice to file in writing with the Clerk of Magistrate Court located at 210 East 4th Street, Woodbine, Georgia, a request for a Probable Cause Hearing. A Probable Cause Hearing Form may be obtained in the clerk’s office. If you fail to request a Probable Causing Hearing within the time allowed the lien will be deemed valid and foreclosure thereof allowed.