UNITED STATES DISTRICT COURT WESTERN DISTRICT OF M ICHIGA N Plaint iff name(s) and address(es) EXECUTION AGAINST PROPERTY CASE NO. JUDGE (6 1 6 ) 4 5 6 -2 3 8 1 Off ice of t he Clerk, 39 9 Federal Building, 110 M ichigan St. , N.W ., Grand Rapids, Michigan 49 50 3 Def endant name(s) and address(es) v REQUEST AND VERIFICATION 1. On D at e , a ju dgment w as grant ed in t his case upon w hich t he f ollow ing is now due: Amount of judgment $ Int erest to t his dat e $ Post judgment cost s $ Total $ Less credits received $ To tal balance due $ Personal jurisdiction w as not acquired over the following defendant(s): The plaint if f requests the Court issue a w rit of execut ion against the propert y of the follow ing defendant(s): 2. 3. I declare that the st atements above are t rue to t he best of my information, know ledge and belief . D at e Address City State Zip Plaintif f / At to rney signatu re Telephone No. WRIT TO ANY SHERIFF, DEPUTY SHERIFF, OR DEPUTY U.S. MARSHAL: IN THE NAME OF THE PEOPLE OF THE UNITED STATES OF AMERICA, YOU ARE HEREBY COMM ANDED: 1. Seize the property described in the att ached judgment for claim and delivery and deliver to the plaintif f(s); or if the property is not found in the possession of the defendant(s), levy the value of it. 2. Seize and sell, according t o law , so mu ch of the personal pro pert y of defendant(s) not exempt from execut ion, as w ill be suf ficient to satisf y plaint if f' s demand and cost s. 3. If sufficient personal property of defendant(s) cannot be f ound w ithin your jurisdict ion, seize and sell so much of the real property of defendant(s) not exempt from execut ion, as will be sufficient to satisf y plaintiff' s demand and cost s. 4. Collect from sale of such property suf ficient monies to pay all of your charges and fees to w hich you are entitled. 5. After service of t his w rit, make proper return in not less than 20 days, nor more than 90 days, from the date of receipt. Clerk D at e Deputy Clerk ENDORSEMENT I certify t hat I received this w rit of execution on D at e at T im e Depu t y Sh erif f / Dep ut y U .S. M arshal American LegalNet, Inc. www.FormsWorkFlow.com PAGE ONE OF TWO CERTIFICATE OF WRIT OF EXECUTION SATISFIED IN FULL/IN PART I certif y, under penalty of contempt of court , that I have levied and collect ed from the defendant(s), in full/in part w ith interest and costs, as I w as ordered, G the amount of judgment. G the property of claim and delivery judgment. $ $ $ A. Balance due judgment c reditor B. Receipts from execution 1. Statutory flat fee 2. Mileage from place of service to court in judicial district/county of service miles $ 3. Fee based on percentage of receipts $ 4. Fee for notice of sale 5. Expenses (itemized below ) C. Total collect ion fees (add items 1 t hrough 5) D. Receipts due judgment creditor (s ubtract C f rom B) E. Uncollected balance (subtract D from A) Itemized expenses: $ $ $ $ $ D at e Depu t y Sh erif f / Dep ut y U .S. M arshal CERTIFICATE OF WRIT OF EXECUTION UNSATISFIED I certif y, under penalty of contempt of court, t hat after diligent search, no pe rsonal or real property of the def endant (s) could be f ound on w hich t o levy the specif ied balance due. D at e Depu t y Sh erif f / Dep ut y U .S. M arshal PAGE TWO OF TWO 3 / 8 /0 2 American LegalNet, Inc. www.FormsWorkFlow.com