Form Cr2e094 - Judgment Lien Amendment Statement

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JUDGMENT LIEN AMENDMENT STATEMENT
DO NOT PHOTOCOPY THIS FORM PRIOR TO USE.
THE FOLLOWING INFORMATION IS SUBMITTED IN ACCORDANCE WITH s. 55.206, FLORDIA
BAR CODE MUST BE LEGIBLE.
STATUES, TO AMEND 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
____________________________________________________________________________ ________________ ___________________
CITY
ST
ZIP
THIS SPACE FOR USE BY FILING OFFICER
4.
__________________________________________________________________
5.
___________________________________________
ENTER FILE NUMBER ASSIGNED TO ORIGINAL JUDGMENT LIEN BY DEPARTMENT OF STATE
DATE JUDGMENT LIEN FILED WITH DEPARTMENT OF STATE
6.
AMENDMENT
THE JUDGMENT LIEN BEARING THE FILE NUMBER INDICATED ABOVE IS AMENDED AS SET FORTH BELOW.
PARTIAL RELEASE
THE JUDGMENT LIEN BEARING THE FILE NUMBER INDICATED ABOVE HAS BEEN PARTIALLY RELEASED AND THE VALUE OF THE LIEN REMAINING
____________________.
$
UNPAID AS OF THE DATE OF THIS STATEMENT
ASSIGNMENT
ALL OF THE JUDGMENT CREDITOR’S RIGHTS UNDER THE JUDGMENT LIEN CERTIFICATE INDICATED ABOVE HAVE BEEN ASSIGNED TO THE NEW
JUDGMENT LIENOWNER WHOSE NAME AND ADDRESS ARE LISTED BELOW.
TERMINATION
THE JUDGMENT CREDITOR NO LONGER CLAIMS A LIEN ON THE PERSONAL PROPERTY UNDER THE JUDGMENT LIEN BEARING THE NUMBER
INDICATED ABOVE.
7.
SHOW NAME AND ADDRESS OF ASSIGNEE AND/OR AMENDMENT INFORMATION HERE: (ATTACH PAGE, IF NECESSARY)
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 Amendment Statement for filing.
OWNER’S ATTORNEY OR AUTHORIZED REPRESENTATIVE TO WHOM ACKNOWLEDGMENT/CERTIFICATION OF FILING
WILL BE MAILED:
____________________________________________________
_____________________________________________________________________________________________________________
Signature of Judgment Creditor or Authorized Representative
NAME
_____________________________________________________________________________________________________________
____________________________________________________
MAILING ADDRESS
Printed Name
__________________________________________________________ ______________________ _________________________
CITY
ST
ZIP
NON-REFUNDABLE PROCESSING FEE:
JUDGMENT LIEN AMENDMENT 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
CR2E094 (03/08)

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