File No. STATE OF NORTH CAROLINA County In The General Court Of Justice Name And Address Of Plaintiff District Court Division-Small Claims PARTIAL EVICTION ORDER TO REMOVE BARRED PERSON FROM PREMISES VERSUS G.S. 42-63(b)Name And Address Of First Defendant Name And Address Of Second Defendant To The Sheriff Of County: A judgment was rendered in this case removing the barred person(s) named below from the premises named below; and you are ordered to remove the barred person(s) from the premises. Name Of Barred Person(s) Description Of Premises (Include Location) Date Of Judgment Date Order Issued Signature Deputy CSC Assistant CSC Clerk Of Superior Court RETURN OF SERVICE This Order was served by removing the named barred person(s) from the premises. I have failed to remove the named barred person(s) from the premises for the following reason: Fee Paid Date Received Name of Sheriff $Fee Paid By Date Executed County Date Returned Signature Of Deputy Sheriff Making Return AOC-CVM-406, New 10/95 1997 Administrative Office of the Courts