Free JUDGEMENT LIEN CERTIFICATE - Florida

SECOND JUDGMENT LIEN CERTIFICATE
FOR PURPOSES OF FILING A SECOND JUDGMENT LIEN, THE FOLLOWING INFORMATION IS SUBMITTED IN ACCORDANCE WITH s. 55.204, FLORIDA STATUTES. THIS SECOND JUDGMENT LIEN IS A NEW LIEN AND NOT A CONTINUATION OF THE ORIGINAL LIEN. 1. __________________________________________________________________________________________
FILE NUMBER ASSIGNED TO THE RECORD OF THE ORIGINAL JUDGMENT LIEN CERTIFICATE:

DO NOT PHOTOCOPY THIS FORM PRIOR TO USE.

BAR CODE MUST BE LEGIBLE.

2. DATE FILED WITH DEPARTMENT OF STATE: ___________________________ ____________________ ,
MONTH DAY

____________ YEAR

3. JUDGMENT DEBTOR (DEFENDANT) NAME AS SHOWN ON JUDGMENT, IF AN INDIVIDUAL, IS:
______________________________________________________________________ LAST NAME _____________________________________ FIRST NAME _________ M. I.

________________________________________________________________________________________________________________________ MAILING ADDRESS _______________________________________________________________________________________ CITY __________ ST ___________________ ZIP

4. ADDITIONAL JUDGMENT DEBTOR, IF AN INDIVIDUAL, IS:
_______________________________________________________________________ LAST NAME _____________________________________ FIRST NAME ________ M.I.

________________________________________________________________________________________________________________________ MAILING ADDRESS ______________________________________________________________________________________ CITY __________ ST ____________________ ZIP

5. JUDGMENT DEBTOR (DEFENDANT) NAME AS SHOWN ON JUDGMENT, IF A BUSINESS ENTITY, IS:
________________________________________________________________________________________________________________________ BUSINESS ENTITY NAME ________________________________________________________________________________________________________________________ MAILING ADDRESS ______________________________________________________________________________________ CITY __________ ST ____________________ ZIP

6. FEDERAL EMPLOYER IDENTIFICATION NUMBER: _________________________________________________________________ 7. DEPARTMENT OF STATE DOCUMENT FILE NUMBER: ______________________________________________________________
PLEASE CHECK BOX IF DOCUMENT NUMBER IS NOT APPLICABLE

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

THIS SPACE FOR USE BY FILING OFFICER

__________________________________________________________________________________________
MAILING ADDRESS

11. AMOUNT REMAINING UNPAID: $________________________________

_______________________________________________________________ ________ _______________ 9.
ST ZIP DEPARTMENT OF STATE DOCUMENT FILE NUMBER: ______________________________________________________________ PLEASE CHECK BOX IF DOCUMENT NUMBER IS NOT APPLICABLE CITY

APPLICABLE INTEREST RATE: __________________________________

INTEREST ACCRUED AMOUNT: $________________________________ 12. NAME OF COURT: ________________________________________________________________

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

________________________________________________________________

_________________________________________________________________________________________
NAME 13. CASE NUMBER: _______________________________________________

_________________________________________________________________________________________
MAILING ADDRESS 14. DATE OF ENTRY: _______________ ____________, _____________ MONTH DAY YEAR ST ZIP

______________________________________________________________ _________ ______________
CITY

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; and, (3) 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

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
CR2E092 (3/08)