PIMA COUNTY CONSOLIDATED JUSTICE COURT 115 NORTH CHURCH AVENUE, TUCSON, AZ 85701-1130 (520)740-3171/TTY#(520)740-3019 PLAINTIFF DEFENDANT CASE NO. ___________________________ REQUEST/JUDGMENT (Name/Address/Phone): (Name/Address/Phone): REQUEST TO THE CLERK: PLEASE ENTER: □ □ □ □ □ □ □ □ Enter dismissal: □ □ with prejudice without prejudice Writ of Execution Issue subpoena(s) - Number Issue transcript Writ of Restitution Satisfaction of Judgment Certified copy of Judgment Other: Signature___________________________________ Signature __________________________________ □ □ Plaintiff □ Authorized Agent Signature □ Defendant Authorized Agent Signature ISSUED this date: Clerk TO THE JUSTICE OF THE PEACE: PLEASE ENTER JUDGMENT: □ Default □ Principle $ __________________ Court Costs $ __________________ Attorney Fees $ __________________ Accrued Interest $ __________________ Other $ __________________ Total $ _________________ With interest at the rate of 10% per annum from the date of judgment until paid in full, plus accruing costs. IT IS SO ORDERED this date: Justice of the Peace Copy of the foregoing mailed this date: to: □ Plaintiff □ Defendant □ Runner Service _____________________________________ Clerk:________________________ JP18 (Rev. 06-01-09)/ec/mt/an/mm White-Court Yellow-Plaintiff Pink-Defendant American LegalNet, Inc. www.FormsWorkFlow.com