RECORD OF UNSATISFIED JUDGMENT DEPARTMENT OF HIGHWAY ________________________________ SAFETY FOLDER NUMBER AND MOTOR VEHICLES BUREAU OF FINANCIAL RESPONSIBILITY IN RE: SMALL CLAIMS COURT NEIL KIRKMAN BUILDING _______________________________ CASE NO. TALLAHASSEE, FLORIDA 32301 ________________________________________________________ Plaintiff(s) v. ________________________________________________________ Defendant(s) YOU ARE HEREBY NOTIFIED THAT: _______________________________________________________________ was/were sued for damages and a judgment of $________________, plus $__________ costs, was rendered on __________________________ against the (date of Judgment) following named Defendant(s) _________________________________________________________________________ (name of Defendant(s) against whom Judgment awarded) in an action for damages to/on ________________________________________________________________________, (property damages or on a promissory note) resulting from the operation of a motor vehicle on _____________________________, in ___________________ County, (date of accident) Florida. As of the date of this letter, no notice of appeal of the aforesaid Judgment has been filed with the Clerk of this Court, nor has the said Judgment been stayed or satisfied according to the records of this Court. Since this Judgment has become final by expiration without appeal, any security that has been deposited by or on behalf of the Judgment debtor pursuant to Section 324.061, Florida Statutes, may be released in full or partial satisfaction of the said Judgment, or such other action taken as is authorized by law. Dated this _______ day of _______________________, 20____, A. D. 2000 © American LegalNet, Inc. ________________________________________ _______________________________________ Creditor's Name Signature of Court Clerk or Judge ________________________________________ _______________________________________ Address Court ________________________________________ _______________________________________ City State Address of Court ________________________________________ Attorney for Creditor c:\civil\forms.8.doc (6/96) 2000 © American LegalNet, Inc.