Case Number (if known):
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Amount of Judgment : |
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Amount Collected To-Date : |
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Date Judgment was Issued - (Month/Day/Year): |
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State in Which Judgment was Issued (eg: Georgia or GA): |
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Country (if USA - Leave Blank): |
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Were You Represented By an Attorney? - (Select Yes/No): |
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Was Your Judgment Awarded By Default? (Defendant was NOT Present) - (Select Yes/No): |
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Does Judgment Debtor (Defendant) Now Reside in a Different State? (Select No/Yes): |
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Name of the Judgment Debtor (Defendant)
First name / Middle initials if known / Last Name: |
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Last known Street Address Of Judgment Debtor: |
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Last Known City, State , Country or ZIP/Post Code of Judgment Debtor: |
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JUDGMENT CREDITOR (JC) - YOUR INFORMATION
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Full Name: (First {Middle initial}, Last) |
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Full Street Address:
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City, State, Country or ZIP/Post Code: |
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Phone Number (please include area code): |
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Email Address: |
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Copy of my Judgment (please make a selection): |
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Please describe your case here (briefly but thoroughly): |
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