Form Cr2e093 - Judgment Lien Correction Statement

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JUDGMENT LIEN CORRECTION STATEMENT
DO NOT PHOTOCOPY THIS FORM PRIOR TO USE.
BAR CODE MUST BE LEGIBLE.
THE FOLLOWING IS SUBMITTED IN ACCORDANCE WITH s. 55.207, FLORIDA STATUTES, AS
INFORMATION ONLY. THE CORRECTION STATEMENT DOES NOT AFFECT THE EFFECTIVENESS OF
THE JUDGMENT LIEN NOR WILL IT CHANGE THE INFORMATION SHOWN ON THE RECORDS OF
THE DEPARTMENT OF STATE.
JUDGMENT DEBTOR(S)
1.
JUDGMENT DEBTOR (DEFENDANT) NAME AS SHOWN ON THE RECORDS OF THE DEPARTMENT OF STATE:
_____________________________________________________________________________________________________________________
INDIVIDUAL OR BUSINESS ENTITY NAME
______________________________________________________________________________________________________________________
MAILING ADDRESS
___________________________________________________________________________ _______________ ________________________
CITY
ST
ZIP
2.
ADDITIONAL JUDGMENT DEBTOR, IF APPLICABLE:
_____________________________________________________________________________________________________________________
INDIVIDUAL OR BUSINESS ENTITY NAME
_____________________________________________________________________________________________________________________
MAILING ADDRESS
___________________________________________________________________________ _______________ _______________________
CITY
ST
ZIP
JUDGMENT CREDITOR(S)
3.
JUDGMENT CREDITOR (PLAINTIFF) NAME AS SHOWN ON THE RECORDS OF THE DEPARTMENT OF STATE:
_____________________________________________________________________________________________________________________
CREDITOR NAME(S)
_____________________________________________________________________________________________________________________
MAILING ADDRESS
THIS SPACE FOR USE BY FILING OFFICER
____________________________________________________________________________ ________________ _____________________
CITY
ST
ZIP
4. ___________________________________________________________________
5. ____________________________________________
ENTER FILE NUMBER ASSIGNED TO ORIGINAL JUDGMENT LIEN BY DEPARTMENT OF STATE
DATE JUDGMENT LIEN FILED WITH DEPARTMENT OF STATE
6.
THE JUDGMENT BEARING THE FILE NUMBER REFERENCED ABOVE, TO MY BELIEF, WAS WRONGFULLY FILED OR THE RECORD IS INACCURATE. THE MANNER IN WHICH THE RECORD SHOULD
BE CORRECTED TO CURE THE INACCURACY IS STATED BELOW:
7. UNDER PENALTY OF PERJURY, I hereby certify that: (1) All of the information set forth above is true, correct, current and complete; and (2) I have complied with all
applicable laws in submitting this Judgment Lien Correction Statement for filing.
8.
NAME AND ADDRESS TO WHOM ACKNOWLEDGMENT/CERTIFICATION IS TO BE MAILED:
____________________________________________________
Authorized Signature
_______________________________________________________________________________________________________________
NAME
____________________________________________________
_______________________________________________________________________________________________________________
Printed Name
MAILING ADDRESS
____________________________________________________________ ______________________ _________________________
NON-REFUNDABLE PROCESSING FEE:
CITY
ST
ZIP
JUDGMENT LIEN CORRECTION STATEMENT $20.00
EACH ATTACHED PAGE, IF NECESSARY $ 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
CR2E093 (03/08)

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