IN THE MAGISTRATE COURT OF CLAYTON COUNTY STATE OF GEORGIA Plaintiff VS. Civil Action File Defendant No. REQUEST FOR WRIT OF FIERI FACIAS The affiant comes before this Court and requests a Writ of Fieri Facias (FIFA) be issued pursuant to consent Judgment to pay payments entered on the case. Affiant states that a total of $ principal amount of $ plus interest due $ plus court costs of $ This day of , , , . , 20 . has been received toward satisfaction of the judgment and defendant(s) having failed to make timely payments, leaving a balance due in the day of , 20 in the above styled for the total outstanding judgment amount of $ Affiant Address: Sworn to and subscribed before me this day of Notary Public/Clerk/Deputy Clerk ( ) area code phone number , 20 . \magistra\fifa.req 10/23/97 American LegalNet, Inc. www.FormsWorkFlow.com