Original - Court 1st Copy - Officer 2nd Copy - Defendant U.S. BANKRUPTCY COURT Western District of Michigan REQUEST AND ORDER TO SEIZE PROPERTY Court Address: One Division NW, Suite 200, Grand Rapids, MI 49503 3rd Copy - Plaintiff BANKRUPTCY CASE NO. ADVERSARY PROCEEDING NO. Defendant name(s) and address(es) Plaintiff name(s) and address(es) V REQUEST AND VERIFICATION 1. On___________________ a judgment was granted in this case upon which the following is now due: (date) Amount of judgment $____________ Interest to this date $__________ Post judgment costs $___________ Total $____________ Less credits received $_________ *Balance due to date $__________ *Additional statutory interest, officer/sheriff fees, and expenses may be charged in addition to the unpaid balance according to law. 2. The plaintiff requests the court authorize the seizure of property of the following defendant(s): _________________________________________________________________________________________________________ Name Date of birth (if available) _________________________________________________________________________________________________________ Name Date of birth (if available) I declare that the statements above are true to the best of my information, knowledge, and belief. ___________________________________ _________________________________________________________ Date Plaintiff/Attorney signature Bar No. ___________________________________________________________________________________________________________ Address City State Zip Telephone no. TO ANY SHERIFF, DEPUTY SHERIFF, OR COURT OFFICER - YOU ARE AUTHORIZED TO: 1. Seize and sell, according to law, any of the personal property (as determined by the officer) of defendant(s) named above in the Request and Verification that is not exempt from seizure, as will be sufficient to satisfy plaintiff's demand, costs, and any statutory fees and expenses. Personal property may include, but is not limited to motor vehicles or money, wherever located. 2. If sufficient personal property of defendant(s) cannot be found within your jurisdiction, seize and sell any of the real property of defendant(s) not exempt from seizure, as will be sufficient to satisfy plaintiff's demand, costs, and any statutory fees and expenses. 3. Collect from the sale of the property enough money to pay all of your statutory fees and statutory expenses. 94. Deposit proceeds of sale with the court after deducting statutory fees and statutory expenses. 95. Claim and Delivery Only: Seize the property described in the attached judgment for claim and delivery and deliver to the plaintiff(s); or if the property is not found in the possession of the defendant(s), levy the value of it. 6. You must endorse the month, day, year, and hour that you receive this order, and that time is the effective date of this order. You must execute and return this order not less than 20 days, nor more than 90 days, from the effective date. If you have begun to serve this order on or before the return date, you must complete the service and return after the return date. 7. You may not continue collecting on this order after the return date except as indicated in item 6. _________________________ __________________________________________________ Date Judge Order to be served by:___________________________________________ Court officer/Deputy Sheriff/Deputy Marshal ENDORSEMENT: I certify that I received this order on ________________________ at _____________________________________ Date Time __________________________________________________ Court officer/Deputy SheriffDeputy Marshal TO THE DEFENDANT: The person seizing property is required to provide you with a receipt of all money paid by you and an inventory of the property seized. MC 19 (6/04) REQUEST AND ORDER TO SEIZE PROPERTY MCL 600.2920, MCL 600.6002, MCR 3.106 28 U.S.C. 564; FRCP 69 American LegalNet, Inc. www.FormsWorkFlow.com