STATE OF MINNESOTA COUNTY OF HENNEPIN IN THE MATTER OF THE APPLICATION OF: _______________________________________ FOURTH JUDICIAL DISTRICT APPLICATION FOR DISCHARGE OF JUDGMENT(S) Please take notice that the undersigned, acting for the judgment debtor(s) listed above, hereby applies for the discharge of the following judgment(s) entered in Hennepin County: Case No. Creditor Date(s) of Docketing Amount A certified copy of the judgment debtor's bankruptcy discharge or certificate by the Clerk of the United States Bankruptcy Court and an affidavit of personal service for each judgment creditor is attached. Minnesota Statute 548.181 requires a filing fee of $5.00 for each judgment. If you have not paid the initial filing fee for the case, you will need to pay $324.00 or $42.00 for a transcript. Date: ___________ Signed: __________________________________ __________________________________ __________________________________ CREDITORS PLEASE NOTE: Pursuant to M.S.A. 548.181, the Court Administrator will discharge the judgment(s) listed within 20 days after service of the application unless an objection to discharge is served on the judgment debtors and filed with the Court Administrator. Creditors may object to discharge if: 1)the debt represented by the judgment was not discharged by the bankruptcy discharge; or 2)the judgment was an enforceable lien on real property when the bankruptcy discharge was entered. Application of Discharge District4 ENG Rev 2/15 www.mncourts.gov/district/4 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com