INSTRUCTIONS FOR COMPLETING THE AFFIDAVIT OF IDENTIFICATION OF JUDGMENT DEBTOR The judgment creditor, or the creditor's agent or attorney must complete this form. 1. 2. 3. Enter the full title of the case. Enter the case number. Enter the judgment debtor's complete name, occupation, place of residence and post office address. Note: If debtor lives in an incorporated place of more than 5,000, the street and number of both residence and business must be given. 4. The judgment creditor, creditor's agent or attorney must list their name, address, telephone number and attorney ID number if appropriate. Sign the form before a Notary Public or before a Hennepin County District Court Clerk in the Civil Division. If you are a creditor's attorney, you must e-file the documents to the Hennepin County District Court through the E-File and Serve system. Pro Se individual, mail the Affidavit of Identification of Judgment Debtor to: Hennepin County District Court C3 Judgment Department 300 South Sixth Street Hennepin County Government Center Minneapolis, MN 55487 OR File the Affidavit of Identification of Judgment Debtor at the Civil Intake counter on the Public Service Level of the Government Center. NOTE: If the case originated in Conciliation Court and you have not yet transcribed (moved) it to District Court, mail the Affidavit of Id along with your transcript request to: Hennepin County Conciliation Court 350 South 5th Street, Room 306 City Hall Minneapolis, MN 55415-0926 Affidavit of ID and Instructions for Debtor Revised 12/4/13 5. 6. 7. American LegalNet, Inc. www.FormsWorkFlow.com FOURTH JUDICIAL DISTRICT STATE OF MINNESOTA COUNTY OF HENNEPIN DISTRICT COURT AFFIDAVIT OF IDENTIFICATION OF JUDGMENT DEBTOR Plaintiff(s) ____________________________________ ____________________________________ Vs Case No. __________________ Defendant(s) ____________________________________ ____________________________________ _________________________________________, being duly sworn, deposes and says; that he/she is the Judgment Creditor, agent or attorney for the Judgment Creditor, and that to the best of his/her knowledge, information, and belief, the full name(s) of the Judgment Debtor(s) in the above-entitled action is as follows: and that the business and occupation of said judgment debtor(s) is as follows: that the present residence is: (number, street, city, state, zip) The above statement of claim is true and correct to the best of my knowledge. Name Signature Address Telephone City/State/Zip Attorney ID Number Note: If debtor is in an incorporated place of more than 5,000, the street and number of both residence and business must be given. Sworn and subscribed to before me this _______ day of ________________, 20___. ____________________________________ Notary/Court Clerk American LegalNet, Inc. www.FormsWorkFlow.com