Distress Petition (Form # DC-423) – Virginia Court

The Distress Petition (Form # DC-423) is a legal document utilized in the Commonwealth of Virginia for cases involving the recovery of rent. This form, in accordance with Virginia Code § 8.01-130.4, is used by plaintiffs to request the court to levy or seize a defendant’s personal property to satisfy an outstanding rent claim. The form includes sections to specify the court, plaintiff(s), defendant(s), and details about the claim, such as the rent amount, bond premium, attorney’s fees, court fees, and storage costs.

The form requires signatures from the plaintiff or their agent/attorney and a notary public to authenticate the statements made. It is a two-page document designed to ensure due process in the recovery of rental debts.

Filling out the Distress Petition (Form # DC-423) correctly is essential for ensuring your claim is processed smoothly. Follow these step-by-step instructions to complete the form:

Case Information

1. • Case No.: Enter the case number assigned by the court.
   • Court Name: Fill in the name of the court where the petition is being filed.

Parties Involved

1. • Plaintiff(s): Provide the full name(s) of the individual(s) or entity filing the petition.
   • Principal Defendant(s): Enter the full name(s) of the individual(s) or entity against whom the petition is filed.
   • Attorney for Plaintiff(s): If applicable, enter the name of the attorney representing the plaintiff(s).
   • Co-Defendant(s): If there are any co-defendants, list their names.

Statement of Claim

1. • Rent: Enter the amount of rent claimed.
   • Bond Premium: If applicable, enter the bond premium amount.
   • Attorney’s Fee: Specify the attorney’s fee as per the contract.
   • Court Fees and Costs: Enter any court fees and costs associated with the claim.
   • Storage Costs: Provide the estimated storage costs up to the hearing date.
   • Total Claimed: Calculate and enter the total amount claimed (sum of the above items).

Details of the Claim

1. • Description and Value: Describe and provide the value of the rent reserved upon contract within the last five years.
   • Property Subject to Distraint:
     • Check the appropriate box (a) for all non-exempt items of personal property located at the defendant’s address or (b) for specific items of personal property.
     • If selecting (b), describe the specific items and their location.

Grounds for Attachment

1. • Grounds for Attachment Number: From the list on page two, enter the applicable number that justifies the attachment.
   • Supporting Facts: Attach and incorporate a list of facts supporting the grounds for attachment.

Specific Relief Requested

1. • Indicate the type of relief requested by checking the appropriate boxes:
     • Levy: To levy the property.
     • Levy and Take into Possession (Seize): To seize the property described.
   • Provide the estimated fair market value of the property to be seized.

Verification

1. • Signature: The plaintiff, plaintiff’s agent, or plaintiff’s attorney must sign the form.
   • Notary Public: The form must be acknowledged, subscribed, and sworn before a notary public. The notary will complete the section with their registration number, signature, and commission expiration date.

Notary Public’s Use Only

1. • State and County/City: Enter the state and either the city or county where the notary is registered.
   • Date: The notary will enter the date of acknowledgment.

Additional Information

1. • Reset Button: Use this if you need to clear all entries and start over.

Tips for Completion

• Ensure all information is accurate and complete.
• Attach any necessary documentation that supports your claim.
• Double-check the form for any errors before submission.

By following these instructions, you can properly complete the Distress Petition (Form # DC-423) and submit it to the appropriate court for processing.