ASSIGNMENT OF CLAIMANT’S RIGHTS

KNOW ALL MEN BY THESE PRESENTS:

That ________________________________, claimant(s), residing at __________________________________________, in consideration of the sums hereinafter set forth, do hereby assign, transfer and set over, to the extent that recovery from the Motor Vehicle Dealer Board, Commonwealth of Virginia, is authorized pursuant to Virginia Law, not to exceed Fifteen Thousand dollars (15,000), that portion of a certain judgment, recovered by assignor on ______________, 19__, in ____________ (court) against __________________________ (name of judgment debtor) for __________ (amount of judgment or amount unpaid upon the judgment). Claimant’s social security number or federal identification number ______________.Assignor hereby irrevocably appoints assignee and it assigns as true and lawful attorney in fact, with power of substitution and revocation, for assignee’s own use and at assignee’s own cost and charges, to demand and receive that portion of the above judgment paid to assignor, take executions, and take in assignor’s name or otherwise all lawful ways and means for the recovery of the money due and on payment to acknowledge satisfaction of or discharge that portion of the judgment.Assignor agrees that assignor will not collect or receive that portion already paid, or any part of that portion paid, nor release or discharge the judgment, but will allow all lawful proceedings therein.

______________________________________________

______________________________________________

In witness hereof, Assignor (s) has/have executed this instrument at _______________,on _____________________, 19___.

ACKNOWLEDGMENT:

State of Virginia

City/County of _________________

Subscribed and sworn to before me this _____________________ day of _____________, by

______________________

NOTARY PUBLIC

My commission expires: ______________________