STATE OF MAINE DISTRICT COURT Location Docket No. REQUEST FOR DISCLOSURE HEARING (Small Claims) M.R.S.C.P. 12(a) Judgment Creditor v. Judgment Debtor On judgment debtor in the amount of $ a small claims judgment was issued against plus costs. The judgment debtor has failed and neglected to comply with the judgment. I request that the Court begin an action that will require the judgment debtor to appear and disclose under oath what assets and income the judgment debtor has which may be used to satisfy the judgment. Date: Judgment Creditor *Note: A request for small claims disclosure cannot be made until 30 days or more have passed from entry of judgment. AUTHORIZATION FOR SERVICE BY SHERIFF If service of the Notice of Disclosure Hearing cannot be completed by acknowledgment or by regular mail, I request sheriff service, and I agree to pay for the service. Date: Judgment Creditor Note: If defendant has a post office box as an address, we will need a street address before we can arrange for a sheriff service. SC-003, Rev. 06/14 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com