File No. STATE OF NORTH CAROLINA Film No. County In The General Court Of Justice District Superior Court DivisionName Of Plaintiff VERSUS ORDER OF SEIZURE IN Name And Address Of Defendant CLAIM AND DELIVERY G.S. 1-474, -475, -477 To The Sheriff Of County: The plaintiff is entitled to immediate possession of the property described in the affidavit or listed below if different. You are ORDERED to take the described property from the defendant and deliver it to the plaintiff after you have been satisfied that the plaintiff has executed a sufficient bond. (Check this block only when order based on default on security agreement.) This Order expires sixty (60) days after it is issued if it has not been served. County In Which Order To Be Served Date Property If Different Than Described In Affidavit Signature Assistant CSC Clerk Of Superior Court PLAINTIFFS BOND, G.S. 1-475 I, as principal, and the undersigned surety do acknowledge ourselves bound in the amount indicated below, for the return of the property to the defendant, with damages for its deterioration and detention, if such return is made. If for any cause return cannot be made, payment shall be made to the defendant of such sum as may be recovered against me for the value of the property at the time of the seizure, with interest thereon as damages for the seizure and detention. Amount Of Bond Signature Of Plaintiff (Principal) $ Signature Of Surety 1 Signature Of Surety 2 Address Of Surety 1 Address Of Surety 2 AFFIDAVIT OF SURETY, G.S. 1-477 The undersigned surety, being first duly sworn says that he/she is a resident of the State of North Carolina, and is worth the amount of the bond, over and above all liabilities and exemptions allowed by law. Signature Of Surety 1 SWORN AND SUBSCRIBED TO BEFORE ME Date Signature Name Of Surety 1 (Type Or Print) Title Of Person Authorized To Administer Oaths Signature Of Surety 2 Date Commission Expires Name Of Surety 2 (Type Or Print) SEAL SHERIFFS APPROVAL Date Bond Approved Signature Of Sheriff AOC-CV-203, Rev. 3/98 1998 Administrative Office of the Courts (Over) >>>> 2 RETURN OF SERVICE I certify that this Order was received and served as follows: Date Served Name Of Defendant By delivering to the defendant personally a copy of the affidavit, bond and Order of Seizure, and by taking from the defendant the personal property described below. By delivering a copy of the affidavit, bond and Order of Seizure at the dwelling house or usual place of abode of the above named defendant with a person of suitable age and discretion then residing therein, and by taking the personal property described below: Name And Address Of Person With Whom Copies Left After holding the property for three (3) days, the defendant has not filed a bond with me, and I have delivered the property to the plaintiff on his/her bond, which was approved by me. The defendant executed a good and sufficient bond as required by law, and the property was delivered back to the defendant. Other manner of service (specify) The property WAS NOT seized for the following reason: Description Of Property Seized: Service Fee Paid Date Received Name Of Sheriff$ Paid By Date Of Return County Deputy Sheriff Making Return AOC-CV-203, Side Two, Rev. 3/98 1998 Administrative Office of the Courts