I
C
C
S
O
N THE
IRCUIT
OURT OF THE
TATE OF
REGON
F
C
M
OR THE
OUNTY OF
ULTNOMAH
Small Claims Department
1021 SW Fourth Avenue
Room 210
Portland, OR 97204
___________________________________
C
N
.
___________________________________
_________________
ASE
O
Plaintiff(s),
v.
S
J
ATISFACTION OF
UDGMENT
F
P
ULL
ARTIAL
___________________________________
___________________________________
Defendant(s).
Plaintiff has received $_____________________ this ________ day of ______________,
20____.
This case is hereby reported as
full
partial satisfaction of judgment.
______
_____
Date
Signature of Creditor
________________________________
_____
Address of Creditor
Print/Type Name of Creditor
____________________________________
City
State
Zip
Contact Number for Creditor
Subscribed and sworn to me this _____________________ day of ___________________,
20________.
By: __________________________________________
Court Clerk/Notary
05-75 (11/13) Satisfaction of Judgment/Partial Satisfaction of Judgment