IN THE COUNTY COURT IN AND FOR CITRUS COUNTY FIFTH JUDICIAL CIRCUIT OF FLORIDA CASE NO: Plaintiff(s) -vs- Defendant(s) AFFIDAVIT OF AMOUNT DUE Before the subscribed personally appeared this date the above named Plaintiff, who being duly sworn, states: That a Defer Judgment / Conditional Dismissal was rendered against the above named Defendant for the sum of $______________ on the ______ day of ______________________, _____. That there still remains due and unpaid the sum of $_______________ together with costs in the sum of $_______________ for which let Final Judgment be entered. ___________________________________ Plaintiff Sworn to and subscribed before me this ______ day of ___________________, 20___. ANGELA VICK Clerk of the Circuit Court and Comptroller By:___________________________________ Deputy Clerk OR ______________________________________ Notary Public COURTS/WEBSITE/WEBSITEFORMS/2013/PL Affidavit of Amount Due 11/20/2015 American LegalNet, Inc. www.FormsWorkFlow.com