Sample Acknowledgement Of Satisfaction Of Judgment Form
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1FOR RECORDER’S OR SECRETARY OF STATE’S USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address):
TELEPHONE NO.:
< - Name/Attorney>
< - telephone>
< - Address>
< - City, State, Zip>
< - enter name>
ATTORNEY FOR (Name):
< - court>
NAME OF COURT:
STREET ADDRESS:
< - street address>
< - mailing address>
MAILING ADDRESS:
< - city and zip code>
CITY AND ZIP CODE:
< - branch>
BRANCH NAME:
PLAINTIFF: < - plaintiff>
DEFENDANT: < - defendant>
CASE NUMBER:
< - case number>
ACKNOWLEDGEMENT OF SATISFACTION OF JUDGMENT
[ < - > ] FULL
[ < - > ] PARTIAL
[ < - > ] MATURED INSTALLMENT
FOR COURT USE ONLY
1.
Satisfaction of the judgment is acknowledged as follows (see
footnote* before completing):
a.
[ < - > ] Full satisfaction
(1) [ < - > ] Judgment is satisfied in full.
(2) [ < - > ] The judgment creditor has accepted
payment or performance other than that
specified in the judgment in full satisfaction
of the judgment.
b.
[ < - > ] Partial satisfaction
The amount received in partial satisfaction of the
judgment is $< - amount>
c.
[ < - > ] Matured installment
All matured installments under the installment judgment
have been satisfied as of (date): < - date>
2.
Full name and address of judgment creditor:
< - name and address>
3.
Full name and address of assignee of record, if any:
< - name and address>
4.
Full name and address of judgment debtor being fully or partially released:
< - name and address>
5.
a.
Judgment entered on (date):
[ < - > ] (1) in judgment book volume no.: < - volume>
(2) page no.: < - page>
b.
[ < - > ] Renewal entered on (date): < - date>
[ < - > ] (1) in judgment book volume no.: < - volume>
(2) page no.: < - page>
6.
[ < - > ]
An [ < - > ] abstract of judgment
[ < - > ] certified copy of the judgment has been recorded as follows
(complete all information for each county where recorded):
COUNTY
DATE OF RECORDING
BOOK NUMBER
PAGE NUMBER
< - COUNTY>
< - date of recording>
< - book number>
< - page number>
7.
[ < - > ]
A notice of judgment lien has been filed in the office of the Secretary of State as file number (specify): < - file
number>
NOTICE TO JUDGMENT DEBTOR: If this is an acknowledgement of full satisfaction of judgment, it will have to be recorded in each
county shown in item 6 above, if any, in order to release the judgment lien, and will have to be filed in the office of the Secretary of
State to terminate any judgment lien on personal property.
Date: < - date>
(SIGNATURE OF JUDGMENT CREDITOR OR ASSIGNEE OF CREDITOR OR ATTORNEY)
*The names of the judgment creditor and judgment debtor must be stated as shown in any Abstract of Judgment which was recorded and is being released by this
satisfaction. A separate notary acknowledgement must be attached for each signature.
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