CIVIL APPEAL BOND Commonwealth of Virginia VA. CODE �� 16.1-107, 16.1-108, 16.1-296 CASE NO. .............................................................................................................................. CITY OR COUNTY [ ] General District Court [ ] Circuit Court [ ] Juvenile and Domestic Relations District Court [ ] General District Court Civil Judgment and Order (Virginia Code �� 16.1-107, 16.1-108) [ ] Juvenile and Domestic Relations District Court (CHECK ONLY ONE PER FORM): [ ] Support arrearage order or judgment (Virginia Code � 16.1-296) [ ] Prospective support accrual during pendency of appeal (Virginia Code � 16.1-296) The undersigned each hereby acknowledges him- or herself, his or hers heirs, and his or her assigns indebted jointly and severally to the Appellee in the sum of $ ......................................... by deposit in the form of, or that is secured by BOND AMOUNT CIVIL APPEAL BOND ................................................................................................................ PLAINTIFF/PETITIONER/COMPLAINANT ................................................................................................................ ADDRESS [ ] cash [ ] bank check [ ] escrow check from appealing party's attorney [ ] surety bond or corporate surety (Virginia Code � 38.2-2405) on behalf of [ ] Plaintiff [ ] Petitioner [ ] Complainant [ ] Defendant/Respondent The undersigned each waives all benefits of the homestead exemption as to this obligation. The condition of this obligation shall be that the undersigned abide by the judgment or order of the court on appeal, or if the appeal is not perfected, by the judgment or order of this court, that the undersigned pay all costs and damages which may be awarded against the party on whose behalf this bond is given in the court on appeal and if judgment was rendered in this court against the party on whose behalf this bond is given, including a judgment or order rendered against him on appeal and guarantee the payment of prospective support accruing during the pendency of the appeal if so ordered by the court in a civil contempt finding or criminal contempt conviction. If the undersigned and the party on whose behalf this bond is given faithfully fulfill the condition above, this obligation is void; otherwise it is to remain in full force and effect until declared void by a court of competent jurisdiction. ............................................................................................................ SURETY'S NAME ................................................................................................................ ................................................................................................................ TELEPHONE NUMBER V. ................................................................................................................ DEFENDANT/RESPONDENT ................................................................................................................ ADDRESS ................................................................................................................ ................................................................................................................ TELEPHONE NUMBER _____________________________________________________ [ ] APPELLANT'S [ ] PRINCIPAL'S SIGNATURE _____________________________________________________ SURETY'S SIGNATURE ............................................................................................................ SURETY'S ADDRESS ............................................................................................................ Acknowledged before me this date: ...................................................... DATE IF BOND GIVEN BY PRINCIPAL OTHER THAN PLAINTIFF OR DEFENDANT, GIVE NAME AND ADDRESS: ................................................................................................................ ................................................................................................................ ................................................................................................................ _____________________________________________________ [ ] CLERK [ ] DEPUTY CLERK [ ] JUDGE FOR NOTARY PUBLIC'S USE ONLY: State of .......................................................................................... [ ] City [ ] County of ................................................................................. Acknowledged, subscribed and sworn to before me this ..................... day of ...................................................................... , 20 ..................... by .......................................................................................................................................... ............................................................................................................ NOTARY REGISTRATION NUMBER ................................................................................................................ ................................................................................................................ ______________________________________________________ NOTARY PUBLIC (My commission expires: ..................................................................... ) American LegalNet, Inc. www.FormsWorkFlow.com FORM DC-460 MASTER 10/11