Small Claims Form 3. 2 3 : Release and Satisfaction of Judgment F In t he Iowa D istrict C ourt for C ounty Plaintiff(s) (Name) (Name) vs. De fendant (s) (Name) (Name) Release and Satisfaction of Judgment Small Claim No. To Judgment D ebtor (s): I ( We ) knowingly and voluntarily state that the judgment in this matter has been paid off or satisfied in full, including inter est and court costs , and I (we) release the D e btor(s) named above from any further obligation on the judgment in this matter . Note : Failure to satisfy an d release a judgment, when paid off or satisfied in full, could result in a penalty of $4 00.00 if not filed within 30 days of written request ( Iowa Code s ection 624.37). Date: Date: Judgment Creditor ( m ust sign before a Notary) Judgment Creditor ( m ust sign before a Notary /s/ /s/ Law firm, or entity for which filing is made, if applicable Law firm, or entity for which filing is made, if applicable Mailing address Mailing address Email address Email address Additiona l e mail address , if applicable Additional email address, if applicable Certification o f Acknowledgment ( Iowa Code s ection 624.37) : On this date , , appeared before me , acknowledged that signing th is Release and Satisfaction of Judgment was a vo luntary and knowing act , and signed the document before me. Date: Notary Public or Clerk of Court American LegalNet, Inc. www.FormsWorkFlow.com