JUDGMENT LIEN DOCKET – SUBSEQUENT ENTRIES COMMONWEALTH OF VIRGINIA Court in which Judgment Docketed: ...................................................................................................................................................................................... Court rendering Judgment (if different): .............................................................................................................................................................................. Date of Judgment: .................................................................................. Original Book No. ........................... , Original Date Docketed: Page ..................... Amount of Judgment: $ OR Original Judgment No. ......................................................................... ........................... OR Instrument No. ...................... ........................................................................... Plaintiff(s): ........................................................................................................................................................................................................................................ Defendant(s): ................................................................................................................................................................................................................................... Type of Filing (Check One) [ ] Release by Payment or Discharge by judgment creditor (Virginia Code § 8.01-453) Check One: [ ] Full [ ] Partial. If partial release to specific piece of property, identify here: ....................................................................................................................................................................................................................................................... [ ] Release or Discharge by Court Order (Virginia Code §§ 8.01-455, 8.01-456). Check One: [ ] Court order of satisfaction or discharge attached. [ ] Court order to mark judgment discharged in bankruptcy attached. [ ] Court order pursuant to Virginia Code § 8.01-456 directing payment to be deposited with the clerk attached. Amount paid to clerk $ ..................................................................... and date paid to the clerk [ ] Assignment (Virginia Code § 8.01-452) Date of Assignment: Name of Assignee .................................................................. .......................................................................... ................................................................................................................................................................................................................ Name of Assignor: ............................................................................................................................................................................................................... [ ] Credit(s) (Virginia Code § 8.01-449) Date paid: .................................................................................................. Amount: $ ..................................................................................... [ ] Name of Additional Debtor ......................................................................................................................... Social Security Number of Debtor (last four digits) (if known) ................................................... [ ] Change of Name of Debtor (Virginia Code § 8.01-451) New Name of Debtor .......................................................................................................................................................................................................... Former Name of Debtor ..................................................................................................................................................................................................... Social Security Number of Debtor (last four digits) (if known) ................................................... NOTICE: Any judgment creditor who knowingly gives false information on this certificate shall be guilty of a class 1 misdemeanor. Date: ..................................................................... ............................................................................................................................................................... [ ] PLAINTIFF [ ] ATTORNEY FOR PLAINTIFF [ ] AGENT FOR PLAINTIFF [AFFIDAVIT FOR ASSIGNMENTS AND NEW NAME OF DEBTOR ONLY] STATE OF ................................................................................... City/County of ............................................................................ Acknowledged, subscribed and sworn to before me this ...................... day of ........................................................................ by .......................................................................................................................................................................................................................................................... ______________________________________________________________________________ [ ] NOTARY PUBLIC [ ] CLERK [ ] DEPUTY CLERK (My Commission Expires: ............................. ) Registration No. .................................................. ............................................................................................................................................................... PRINT NAME OF NOTARY FORM CC-1462 MASTER 07/08 VA. CODE § 8.01-446.1 American LegalNet, Inc. www.FormsWorkflow.com