Va. Code § 8.01-241.1: Permissible form for certificate

Any extension of the limitations of the right to enforce the lien of a deed of trust or mortgage shall conform substantially with the following form:CERTIFICATE OF EXTENSION OF LIMITATION OF RIGHT TO ENFORCE DEED OF TRUST OR MORTGAGEPlace of Record...........................................................…Date of Deed of Trust/Mortgage...........................................…Deed Book..............… Book Page....................................…Name of Guarantor(s)......................................................…Name of Trustee(s)........................................................…Maker(s) of Note..........................................................…Date of Note(s)...........................................................…I/we, the beneficial title holder(s) of the property encumbered by the above mentioned deed of trust/mortgage, do hereby certify that the lien of the same is hereby extended 10 years from the date of my/our endorsement upon this certificate............................................................…Beneficial Titleholder/Attorney-in-Fact/AgentCommonwealth of VirginiaCounty/City of................…:Subscribed, sworn to and acknowledged before me by...........…, this … day of........, 20 …My Commission expires:................…Notary Public1994, c. 547; 2008, c. 226.