COMMONWEALTH OF PENNSYLVANIA COUNTY OF Request for Order of Execution Mag. Dist. No: MDJ Name: Address: vs. Telephone: ( ) Docket No: Case Filed: Judgment Date: Amount of Judgment Interest on Judgment Judgment Costs Order of Execution Total $ $ $ $ $ TO , MAGISTERIAL DISTRICT JUDGE : The plaintiff, having obtained a judgment against defendant for payment of money in the above amount, requests you to issue an Order of Execution thereon. Date Request Filed: AM/PM Time Filed: (Plaintiff) ORDER OF EXECUTION TO , SHERIFF /CERTIFIED CONSTABLE: To satisfy the above judgment, interest and costs, you are directed to levy upon property of the defendant subject to levy under PA. R.C.P.M.D.J. No. 406 and to sell defendant's interest therein. Dated: Magisterial District Judge Received by (Sheriff/Certified Constable) , on (Date) at (Time) AM/PM MDJS 305ABL 1 American LegalNet, Inc. www.FormsWorkFlow.com