STATE OF MINNESOTA FOURTH JUDICIAL DISTRICT COUNTY OF HENNEPIN DISTRICT COURT AFFIDAVIT OF INCREASED COSTS __________________________________ Plaintiff vs. Case No. ________________________ __________________________________ Defendant ________________________________, being duly sworn, on oath says that she/he is the agent/pro se for the Prevailing Party in the above-entitled action; that the following is a true statement of the increased costs incurred; that each and every item thereof has actually and necessarily been paid or incurred in the enforcement of the judgment entered in the aboveentitled action. Execution Fee $_______________________ Service Fee $_______________________ Sheriff Fees $_______________________ Order for Disclosure $_______________________ Order to Show Cause $_______________________ Service Fee for Order to Show Cause $_______________________ Other Increased Costs $_______________________ $_______________________ Total: $_______________________ ______________________________ Signature ______________________________ Printed Name Subscribed and sworn to before me this _____ day of _______________, 20___ ________________________________ Notary Public Last Revised 11/23/04 American LegalNet, Inc. www.FormsWorkflow.com