Certificate of Non-Satisfaction of Decree (O.21, R.6.)

(Title)

CERTIFIED that no (1) satisfaction of the decree of this Court-in suit No..........of 19........, a copy which is hereunto attached, has been obtained by execution within the jurisdiction of this Court.

Dated the .........day of........ 19.............

Judge.

1.      If partial, strike out "no" and state to what extent.