DEFICIENCY JUDGMENT INFORMATION ­ AUTO LEASE Defendant(s) against whom Judgment sought: Case No.:_________________ Lessor: _______________________________________ Lessee: _______________________________________ Date of Lease ( submit original ) ____________________ Vehicle leased ___________________________________ Date of Default _____________________ Date of Repossession _______________ Date of termination invoice ( submit copy) _______________ Date of resale_________________ Amount of resale $ _______________ Name of purchaser on resale _____________________________________________ Capitalized cost...................................................................................... $ ____________________ Less accumulated reserve ..........$ ___________ Less security deposit ......................$ ___________ Less highest bid...................................$___________ $___________________ Plus sales tax SUBTOTAL Plus unpaid rentals............................$____________ Plus (others, define)..........................$____________ TOTAL DUE $__________________ $ __________________ $___________________ Less amount paid AFTER suit.........................................................$ _________________ Amount claimed by you in Default Judgment as PRINCIPAL............. $ _________________ ATTORNEY FEES................. $ _________________ INTEREST.................................. $ _________________ COSTS.......................................... $ _________________ DATE:_____________________ ____________________________ (SIGNATURE) DEF ­ 9/2015 _____________________________ NAME- PLEASE PRINT American LegalNet, Inc. www.FormsWorkFlow.com