Form Jgm104 - Affidavit Of Identification Of Judgment Debtor

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State of Minnesota
District Court
County
Judicial District:
Select County
Court File Number:
Case Type:
Civil
___________________________________________
___________________________________________
Affidavit of Identification
___________________________________________
of Judgment Debtor
Plaintiff
(Minn. Stat. §548.09, subd. 2)
vs.
___________________________________________
___________________________________________
___________________________________________
Defendant
STATE OF MINNESOTA
)
)
ss.
COUNTY OF _________________)
(County where Affidavit signed)
___________________________________________ being duly sworn/affirmed on oath says; that he/she is the Judgment
Creditor, or the _________________________ for the Judgment Creditor, that to the best of his/her knowledge,
information, and belief, the full name(s) of the Judgment Debtor(s) in the action above entitled is as follows:
That the business and occupation of said judgment debtor(s) is as follows:
That the place(s) of residence of said judgment debtor(s) is as follows:
That the place(s) of business of said judgment debtor(s) is as follows:
That the post office address(es) of said judgment debtor(s) is as follows:
Dated:
Signature (Sign only in front of notary public or court administrator.)
Name:
Subscribed and sworn to before me this
Address:
day of
,
.
City/State/Zip:
Telephone:
Notary Public\Deputy Court Administrator
JGM104
State
ENG
Rev 8/08
Page 1 of 1

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