Free Judgment Lien Certificate - Connecticut

JUDGMENT LIEN CERTIFICATE
Office of the Secretary of the State
MAILING ADDRESS: Commercial Recording Division Connecticut Secretary of the State P.O. Box 150470 Hartford, CT 06115-0470 860-509-6002
SPACE FOR OFFICE USE ONLY

DELIVERY ADDRESS Commercial Recording Division Connecticut Secretary of the State 30 Trinity Street Hartford, CT 06106 860-509-6002
Fee: $25.00

1. Judgment Debtors Full Legal Name 1a. ORGANIZATION'S NAME OR 1b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

1c.

MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

2. Additional Judgment Debtors Full Legal Name 2a. ORGANIZATION'S NAME OR 2b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

2c.

MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

3. Judgment Creditors Full Legal Name 3a. ORGANIZATION'S NAME OR 3b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

3c.

MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

4. Additional Judgment Creditors Full Legal Name 4a. ORGANIZATION'S NAME OR 4b. INDIVIDUAL'S LAST NAME FIRST NAME MIDDLE NAME SUFFIX

4c.

MAILING ADDRESS

CITY

STATE

POSTAL CODE

COUNTRY

5.

Court in which Judgment was rendered

6. Date of Judgment

7. Original Judgment Amount

8. Amount Due

9. Personal Property on which lien is placed

10. Judgment Creditor Signature

11. Date

Reference an 8 ½ x 11 attachment if additional space is required REV. 05/24/2007