Judgment Lien Certificate Form - Connecticut Secretary Of State
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2SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6002
PHONE:
WEBSITE:
JUDGMENT LIEN CERTIFICATE
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING FEE: $50
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
CUSTOMER ID:
MAKE CHECKS PAYABLE TO "SECRETARY
NAME:
OF STATE"
ADDRESS:
CITY:
STATE:
ZIP:
1. JUDGMENT DEBTORS FULL LEGAL NAME
1A. ORGANIZATION’S NAME
OR
1B. INDIVIDUAL'S
LAST NAME
FIRST NAME
MIDDLE
SUFFIX
1C. MAILING ADDRESS:
ADDRESS:
CITY:
STATE:
ZIP:
COUNTRY:
2. ADDITIONAL JUDGMENT DEBTORS FULL LEGAL NAME
2A. ORGANIZATION’S NAME
OR
2B. INDIVIDUAL’S
LAST NAME
FIRST NAME
MIDDLE
SUFFIX
2C. MAILING ADDRESS:
ADDRESS:
CITY:
STATE:
ZIP:
COUNTRY:
FORM UJPERS-1-1.0
PAGE 1 OF 2
Rev. 7/2010
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