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________________________________________________________________________________
(NAME OF COURT)
_______________________________
_____________________________________
(DOCKET NUMBER)
(PAGE NUMBER)
______________________________
(PLAINTIFF)
NOTICE TO THE DIRECTOR OF THE NEW
vs.
JERSEY MOTOR VEHICLE COMMISSION
TRENTON, N.J.
_______________________________
(DEFENDANT)
__________________________ ______________________
______________ ___________
(NAME OF JUDGMENT DEBTOR) (N.J. DRIVER LICENSE NO.)
(DATE OF BIRTH) (EYE COLOR)
________________________________________________________________________________
(ADDRESS OF JUDGMENT DEBTOR)
On _________________________ warrant for satisfaction was filed with this court in the above case.
(DATE)
________________________________________________________________________________
(To be filled out by the court)
On ________________________ this court issued an order permitting the judgment debtor, in the
above case, to pay the judgment in installments as provided for by Title 39, Chapter 6, Section 39.
This case was previously reported to the Director of Motor Vehicle Services on
________________________ as an unsatisfied judgment coming within the scope of the Security-
Responsibility Law.
____________________________
(SIGNATURE)
NOTE: The Security-Responsibility Law, Title 39, Chapter 6 provides - upon filing with the court of proof of satisfaction or discharge of
a judgment, or when an order is issued permitting payment of the judgment in installments, the nonpayment of which has been
previously certified to the director, the Clerk of the court, or the court where it has no Clerk, shall immediately forward notice of such
satisfaction or discharge or payment in installments to the director.
SR-39 (R12/78)
Revised 12/78, CN 11402-English