IN THE COUNTY COURT OF POLK COUNTY, FLORIDA CLAIMS DIVISION CASE NO. ___________________________ PLAINTIFF, vs. DEFENDANT. FINAL JUDGMENT It is adjudged that the plaintiff, _______________________________, recover from the defendant, _________________________________ the sum of _______________ on principal, _______________ as prejudgment interest, $-0- for attorneys' fees, with costs of _____________, all of which shall bear interest at the rate of ______per year as provided for by Florida Statute, for all of which let execution issue. It is further ordered and adjudged that the defendant(s) shall complete Florida Small Claims Rules Form 7.343 (Fact Information Sheet) and return it to the plaintiff's attorney, or to the plaintiff if the plaintiff is not represented by an attorney, within 45 days from the date of this final judgment, unless the final judgment is satisfied or a motion for new trial or notice of appeal is filed. Jurisdiction of this case is retained to enter further orders that are proper to compel the defendant(s) to complete form 7.343 and return it to the plaintiff's attorney, or the plaintiff if the plaintiff is not represented by an attorney. ORDERED this ______ day of_________________, ______. ________________________________ County Court Judge Copies furnished to parties at addresses shown above. American LegalNet, Inc. www.FormsWorkFlow.com