Levy Request Form - Fairfax County Circuit Court
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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)
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CCR-G-150 LEVY REQUEST FORM (July 2011)
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Parent category: Legal