CASE FILING INFORMATION
Case No. VS
Judgment type: Open A ccount W orthless Check Contract w/Prejudg ment interest
Contract w/ contract rate interest Action for Possession, Lease/Foreclosure Other Subrogation
COUNT
I
II
III
Principal/Face amount of Check(s) Prejudgment interest (percent) Date to Judgment (beginning date of prejudgment int) Postjudgment interest (percent or Statutory) Damages Possession* Attorney fees Court Costs (yes/no) Other ** Eviction (yes/blank) Set for Damages (Yes/blank) Date for Damage hearing
*
**
Attorney/plaintiff signature Revised 9/3/02