Levy Request {CCR-G-150}

V I R G I N I A: FAIRFAX CIRCUIT COURT ________________________________________ PLAINTIFF CASE #: CL-___________-_______________ VS JUDGMENT #:__________________________ __________________________________ DEFENDANT LEVY REQUEST The Clerk of the court will please forward to the Sheriff of ________________________ an execution against __________________________________________________ who is located at ______________________________________________________________________________ ______________________________________________________________________________ The Sheriff of ______________________________ will levy on the following: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Judgment against said Defendant was obtained on _______________________________ in the principal amount of _________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________ (Attorney/Pro Se Signature) _____________________________________ (Attorney/Pro Se Name) _____________________________________ (Address) _____________________________________ ___________________ _________________ (Phone Number) (Attorney Bar Number) CCR-G-150 LEVY REQUEST FORM (July 2011) American LegalNet, Inc. www.FormsWorkFlow.com