Va. R. Sup. Ct. Form 5
(Circuit Court case caption)
| Plaintiff/Petitioner | ) | |
| v. | ) | No. _______________ |
| Defendant/Respondent | ) |
The Appellant(s), __________________, appealed from a judgment of this Court rendered on ________, 2___, and (the Supreme Court of Virginia) (Court of Appeals of Virginia), on ________, 2___, awarded an appeal (and suspension) from the judgment on the condition that Appellant(s), or someone on Appellant's/AppeIIants' behalf, file a bond with sufficient security in the clerk's office of this Court in the penalty of $________ within fifteen (15) days of the date of the certificate of appeal, with condition as the law directs. Accordingly, we __________________, as principal and __________________, as surety, bind ourselves, our heirs, successors, personal representatives and assigns, jointly and severally, to Appellee(s), __________________, in the sum of $______________, to pay all damages, costs, and fees that may be awarded against (him) (her) (them) (it) in the (Court of Appeals and Supreme Court, if it takes cognizance of the claim) (Supreme Court), and all actual damages incurred in consequence of the suspension.
Va. Sup. Ct. Form 5