Free JUDGEMENT LIEN CERTIFICATE - Florida


File Size: 47.4 kB
Pages: 1
File Format: PDF
State: Florida
Category: Secretary of State
Author: Florida Department of State
Word Count: 346 Words, 4,226 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://form.sunbiz.org/pdf/jlien_cert.pdf

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Preview JUDGEMENT LIEN CERTIFICATE
JUDGMENT LIEN CERTIFICATE
FOR PURPOSES OF FILING A JUDGMENT LIEN, THE FOLLOWING INFORMATION IS SUBMITTED IN ACCORDANCE WITH s. 55.203, FLORIDA STATUTES. 1.
JUDGMENT DEBTOR (DEFENDANT) NAME AS SHOWN ON JUDGMENT, IF AN INDIVIDUAL, IS:

DO NOT PHOTOCOPY THIS FORM PRIOR TO USE. BAR CODE MUST BE LEGIBLE.

___________________________________________ __________________________________ _______
LAST NAME FIRST NAME M. I.

________________________________________________________________________________________
MAILING ADDRESS

_____________________________________________________ _____________ __________________
CITY ST ZIP

2. ADDITIONAL JUDGMENT DEBTOR, IF AN INDIVIDUAL, IS: ___________________________________________ __________________________________ _______
LAST NAME FIRST NAME M. I.

________________________________________________________________________________________
MAILING ADDRESS

_____________________________________________________ _____________ __________________
CITY ST ZIP

3.

JUDGMENT DEBTOR (DEFENDANT) NAME AS SHOWN ON JUDGMENT, IF A BUSINESS ENTITY, IS:

________________________________________________________________________________________
BUSINESS ENTITY NAME

________________________________________________________________________________________
MAILING ADDRESS

_____________________________________________________
CITY

______________ ________________
ST ZIP

4. 5.

FEDERAL EMPLOYER IDENTIFICATION NUMBER: _____________________________________________________ DEPARTMENT OF STATE DOCUMENT FILE NUMBER: ____________________________________________
PLEASE CHECK BOX IF DOCUMENT NUMBER IS NOT APPLICABLE

6.

JUDGMENT CREDITOR (PLAINTIFF) NAME AS SHOWN ON JUDGMENT OR CURRENT OWNER OF JUDGMENT, IF ASSIGNED:
______________________________________________________________________________________________________________________ CREDITOR NAME (S)

____________________________________________________________________________________________________
MAILING ADDRESS

______________________________________________________ _______________ _______________
CITY ST ZIP

7.

DEPARTMENT OF STATE DOCUMENT FILE NUMBER: ____________________________________________
PLEASE CHECK BOX IF DOCUMENT NUMBER IS NOT APPLICABLE

THIS SPACE FOR USE BY FILING OFFICER

8.

OWNER'S ATTORNEY OR AUTHORIZED REPRESENTATIVE: (ACKNOWLEDGMENT OF FILING WILL BE SENT TO THIS ADDRESS)

11. NAME OF COURT:
____________________________________________________________ ____________________________________________________________

______________________________________________________________________________
NAME

________________________________________________________________________________________
MAILING ADDRESS

12. CASE NUMBER: ______________________________________________ 13. DATE OF ENTRY: ________________
MONTH ________ , ___________ DAY YEAR

______________________________________________________ ______________ ________________
CITY ST ZIP

9.

AMOUNT DUE ON MONEY JUDGMENT: _______________________________________________________________

10. APPLICABLE STATUTORY INTEREST RATE: ___________________________________________________________
UNDER PENALTY OF PERJURY, I hereby certify that: (1) The judgment above described has become final and there is no stay of the judgment or its enforcement in effect; (2) All of the information set forth above is true, correct, current and complete; (3) I have not previously filed a Judgment Lien Certificate regarding the above judgment with the Department of State; and, (4) I have complied with all applicable laws in submitting this Judgment Lien Certificate for filing.
______________________________________________________________________________________ SIGNATURE OF CREDITOR OR AUTHORIZED REPRESENTATIVE _______________________________________________________________________________ PRINT NAME

NON-REFUNDABLE PROCESSING FEE: JUDGMENT LIEN WITH ONE DEBTOR $ 20.00 EACH ATTACHED PAGE, IF NECESSARY $ 5.00 EACH ADDITIONAL DEBTOR $ 5.00 (NO CHARGE FOR CREDITOR AFFIDAVIT)

CERTIFIED COPY REQUESTED $10.00 Division of Corporations P.O. Box 6250 Tallahassee, Fl 32314 850-245-6011 Make Checks Payable to: Florida Department of State
CR2E091 (04/08)