                                 CODE OF VIRGINIA

FORM OF CONFESSION OF JUDGMENT (§ 8.01-436)

On the presentation of any such power of attorney as is mentioned in § 8.01-435
by any of the persons therein named as attorney-in-fact, or on the personal
appearance of the debtor and the expression by him of his desire to confess such
judgment, the clerk of the court mentioned in such power of attorney, or before
whom such debtor shall so appear, shall draw and require the attorney-in-fact so
appearing, or the debtor, as the case may be, to sign a confession of judgment,
which shall be in form substantially as follows:
		&#8220;Virginia: In the clerk&#8217;s office of the __________ court of the
__________ of __________, I, (or we) A.B., (or A.B. and C.D., etc.) hereby
acknowledged myself (or ourselves) to be justly indebted to, and do hereby
confess judgment in favor of (name of creditor) in the sum of __________ dollars
($_____) with interest thereon from the __________ day of __________, two
thousand __________, until paid, and the cost of this proceeding (including the
attorney&#8217;s fees and collection fees provided for in the instrument on
which the proceeding is based) hereby waiving the benefit of my (or our)
homestead exemptions as to the same, provided the instrument on which the
proceeding is based carries such homestead waiver.
		Given under my (or our) hand, this __________ day of __________, two thousand
and __________
		(Signatures)
		or, if by an attorney-in-fact, signatures and seals of debtors,
		By ____________________
		his (or their) attorney-in-fact.&#8221;

HISTORY: Code 1950, § 8-360; 1977, c. 617.