Case No. Court þ County þ Division þ þ PLAINTIFFName: Address: þ þ VS. þ DEFENDANTName: Address: þ þ þ On , as Plaintiff Defendant recovered a judgment of $ against , with interest at % per annum and $ as costs. þ þ þ þ þ þ þ þ þ þ þ þ þ Plaintiff Defendant was the owner of the judgment and was entitled to receive payment. þ I hereby request that the Court authorize and direct the Clerk of Court to enter into the record satisfaction of þ þ þ þ Note: Plaintiff/Defendant must sign this in the presence of the Circuit Clerk so that the Clerk can notarize his/her signature. Date: , 2. þ þ (Signature) Subscribed and sworn to before me by this day of , 2. þ þ Clerk þ By:D.C. Distribution: File þ Plaintiff Defendant AOC- 191Rev. 6-17Page 1 of 1Commonwealth of KentuckyCourt of Justice www.courts.ky.govKRS 24A.200 et seq.; 360.040;CR 79.02MOTION FOR SATISFACTION OF JUDGMENT(SMALL CLAIMS) lexet justitia COMMONWEALTHOFKENTUCKY COURTOFJUSTICE District Small Claims (Date) þ (Name) þ (Name) American LegalNet, Inc. www.FormsWorkFlow.com