Alexandria, VA · City of Alexandria
Owner's Written Statement
Property owners or their agents use this statement to certify they are not subject to contractor licensure and accept responsibility for permitted work.
What this form is
This statement is for a property owner or owner's agent who is not a licensed architect, engineer, or contractor and is acting as the contractor for a project. It identifies the property and has the signer certify that they are not subject to contractor or subcontractor licensure, understand permits will be in their name, and accept responsibility for the work.
Who needs it
An owner or owner's agent acting as contractor for a project can use this statement to certify their licensing status and responsibility for the work.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; it has a signature and date line, and the signer just signs and dates it.
How to submit this form
- 1
Download The Statement
Download the Owner's Written Statement PDF.
- 2
Complete The Statement
Enter the owner's name and property location, then review the certification and responsibility statements.
- 3
Sign And Date
The owner or owner's agent signs and dates the statement.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Owner's Written Statement certify?
- The owner or agent certifies they are not subject to contractor or subcontractor licensure, understand permits will be in their name, and accept responsibility for the work.
- Who completes this statement?
- A property owner or owner's agent who is not a licensed architect, engineer, or contractor and is acting as contractor for the project completes and signs it.
- Do I need a notary for the Owner's Written Statement?
- No. The document has a signature and date line; the signer just signs and dates it. It does not mention a notarized or sworn attachment.
- How do I submit the Owner's Written Statement?
- Submit it to the city department named on the form; check the city website for current contact details.