CIV-505 (12/13)(cs) AS 09.38.080(b); Civil R. 69(g)(3) CREDITOR'S AFFIDAVIT IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT ) ) Plaintiff(s), ) vs. ) ) ) CASE NO. Defendant(s). ) ) CREDITOR'S AFFIDAVIT I, the undersigned , upon oath or affirmation and under penalty of perjury, state as follows: 1. I am: the judgment creditor the attorney for the judgment creditor an employee who is authorized in writing to sign on behalf of a judgment creditor , which is a corporation. 2. The judgment creditor has obtained a judgment against in the total amount of $ . (judgment debtor) 3. I have knowledge of the facts of the collection efforts made to date by the judgment creditor on the judgment. 4. The judgment creditor will attempt has attempted to satisfy the judgment by levying against the following property, which the creditor believes is not exempt and is not property of a type subject to value limitations of AS 09.38.020. Description of Property: 5. The judgment creditor believes the above listed property is not exempt for the following factual reasons: Date Signature Printed Name and Title Mailing Address City State ZIP Subscribed and sworn to or affirmed before me at , Alaska on . (date) (SEAL) Clerk of Court, Notary Public, or other person authorized to administer oaths. My commission expires Distribute: 1. Original to court 2. Copy to Debtor 3. Copy to Creditor American LegalNet, Inc. www.FormsWorkFlow.com