STATE OF SOUTH DAKOTA ) IN CIRCUIT COURT )ss: COUNTY OF _______________ ) ____________ JUDICIAL CIRCUIT ______________________________________________________________________________ ) __________________________________, ) File No. ___________ Obligee, ) vs. ) NOTICE OF ENTRY OF ) ORDER AND JUDGMENT AWARDING __________________________________, ) LATE FEES, PER SDCL 25-7-38, Obligor. ) AND AFFIDAVIT OF MAILING ______________________________________________________________________________ PLEASE TAKE NOTICE that the Order and Judgment Awarding Late Fees Per SDCL 25-7-38 was entered in the above-entitled matter on the _______ day of ____________________, 20______, by the Honorable ___________________________ and duly filed by the County Clerk of Courts at ________________________________, South Dakota. A certified copy of said Order and Judgment Awarding Late Fees Per SDCL 25-7-38, along with a copy of this Notice of Entry of Order and Judgment Awarding Late Fees Per SDCL 25-7-38 (put an "X" besides the statement that applies): _______ _______ is attached hereto and served upon you; or was hand-delivered to _______________________________________ at ____________________________, South Dakota. Dated this ________ day of _______________________, 20____. ____________________________________ Obligee (Signature) ____________________________________ Print your name ____________________________________ Physical address ____________________________________ City, State, ZIP code ____________________________________ Telephone number Page 1 of 2 UJS-133 Notice of Entry of Order and Judgment Awarding Late Fees Rev. 06/2012 American LegalNet, Inc. www.FormsWorkFlow.com AFFIDAVIT OF MAILING I, ____________________________________________, being sworn, state that on (Full legal name of Obligee) __________________________________, 20_____, I served the a certified copy of the Order and Judgment Awarding Late Fees Per SDCL 25-7-38 and a copy of the Notice of Entry of Order and Judgment Awarding Late Fees Per SDCL 25-7-38 by placing a true and correct copy of the document in an envelope addressed to: ___________________________________ at ________________________ (Full legal name of Obligor) ____________________________________ in the City of _________________________, State of (Obligor's mailing address) _______________, Zip Code _________ and depositing the envelope, with sufficient postage, in the United States Mail at ___________________________________________________________. (City and State mailed from) Dated this __________ day of ________________________, 20______. _________________________________________ Signature of Obligee (Sign only in front of a Notary or Clerk of Courts) Name: (Printed) _______________________________ Sworn/affirmed before me this _______ day of _____________, _____. ________________________________ (Notary Public/Clerk of Courts) Address: _________________________________ City/State/Zip: ____________________________ Telephone: (_____)________________________ If Notary, my commission expires:_____________________ (SEAL) Page 2 of 2 UJS-133 Notice of Entry of Order and Judgment Awarding Late Fees Rev. 06/2012 American LegalNet, Inc. www.FormsWorkFlow.com