Va. Sup. Ct. R. pt. 5, Form 10

(Name and Address of Bank)

______________, 20____

U.S. $____________

On all communications please refer to (No. of Letter of Credit)

(Name and address of appellee(s))

Dear ______________:

We hereby establish our Irrevocable Letter of Credit No. ____________ in your favor,

for the account of (name and address of appellant(s)), and hereby undertake to honor your

draft at sight on us, not exceeding in the aggregate U.S. $ (amount in words). A draft

drawn under this letter of credit must be mark ed “Drawn under (Name of Bank) Letter of

Credit No. ________________ dated ______________, 20____. ” Funds under this letter

of credit will be available to you in a single drawing by presentation of your sight draft

drawn on us, accompanied by:

(For Costs Alone)

1. The original of this letter of credit.

2. Your verified statement that (appellant(s) (has)(have) faile d to pay all damages,

costs and fees assessed against (him)(her)(them)(it) in the Supreme Court of Virginia in

the case of _____________________ _____________

3. A certified copy of an order or itemized statement of costs from the Supreme Court

assessing such damages, costs and fees against (appellant(s).

(For Suspension Alone)

1. The original of this letter of credit.

2. Your verified statement that (appellant(s) (has)(have) failed to perform and

satisfy the judgment rendered against ( him)(her)(them)(it) on

________________________ by the Circuit Court of ________________________ in

the case of ______________________________, and (has)(have) failed to pay all actual

damages incurred in consequence of the suspension of judgment.

3. A copy of the trial court judgment order, attested by its clerk.

4. A copy of an order of the Supreme Court of Virginia, attested by its clerk, aff irming

the judgment or refusing, dismissing or allowing withdrawal of the appeal of the

judgment, or certificati on by the clerk of the Supreme Court that the appeal of the

judgment was not prosecuted timely.

5. A copy of an order, if any, of the Supreme C ourt or trial court, attested by the clerk,

assessing actual damages in consequence of the suspension of judgmen t.

(For Costs and Suspension)

1. The original of this letter of credit.

2. Your verified statement that (appellant(s) (has)(have) fai led to perform and satisfy

the judgment rendered against (him)(her)(them)(it) on ________________________ by

the Circuit Court of ________________________ in the case of

______________________________, and (has)(have) failed to pay all damages, costs

and fees assessed against (him)(her)(them)(it) in the Supreme Court of Virginia, and all

actual damages incurred in c onsequence of the suspension of judgment.

3. A copy of the trial court judgment order, attested by its clerk.

4. A copy of an order of the Sup reme Court, attested by its clerk, affirming the judgment

or refusing, dismissing or allowing withdrawal of the appeal of the judgment, or

certification by the clerk of the Supreme Court that the appeal of the judgment was not

prosecuted timely.

5. A copy of an order, if any, of the Supreme Court, attested by its clerk, assessing

damages, costs and fees against (appellant(s)).

6. A copy of an order, if any, of the Supreme Court or trial court, attested by the clerk,

assessing actual damages in cons equence of the suspension of judgment.

This letter of credit is valid until ____ p.m. local time ________, 20__ __, and a draft

drawn hereunder, if accompanied by documents as specified above, will be honored if

presented to (Presentation Address of Bank) on or before that date. However, this letter

of credit automatically will be renewed for successive one (1) ye ar periods from the

initial expiration date or any renewal period expiration date hereu nder, unless at least

sixty (60) days prior to any such e xpiration date (Name of Bank) notifies you that it has

elected not to renew this letter of credit for such add itional one (1) year period. The

notice required hereunder will be deemed to have been given when received by you.

In the event that (Name of Bank) elects not to renew this letter of credit as required

above, the full amount of this letter of credit is payable to the Clerk of the Circuit Court

of ______________ upon presentation of your ver ified statement that:

1. A final order of the Supreme Co urt of Virginia has not been entered in the case of

________________________________________ (or, where there ha s been suspension

of judgment, a final order has not been entered by the Supreme Court or trial court

assessing actual damages in consequence of the suspension).

2. Thirty (30) days have elapsed since notice of non-renewal was given and appellant(s)

(has)(have) not filed acceptable substitute security.

In the event of non-renewal, within fifteen (15) days after payment to the clerk

under the pre vious paragraph, the appellant(s) or someone for (him)(her)(them)(it) must

file with the clerk of the trial court an appeal bond in substantial conformance with the

appropriate form in the Appendix to Part Five A of the Rules of the Supreme Court of

Virginia. The bond must be in the penalty of the amount paid to the clerk under this letter

of credit, and the funds are in lieu of surety, but in no event will we have any liability or

responsibility for failure of the appellant(s) (or someone acting on (appell ant’s)

(appellants’) behalf) to file such bond.

Partial drawings are not permitted under this letter of c redit.

Except as otherwise expressly stated above, this letter of credit is subject to the

International Standby Practices 1998 (ISP98) ( International Chamber of Commerce

Publication No. 590) and, to the extent consistent with ISP98 and the express provisions

above, the provisions of Title 8.5A of the Code of Virginia governing letters of credit.

Very truly yours,

__________________________________ Bank

By_____ _______________________________

Authorized Signature