State of Minnesota County Hennepin District Court Judicial District 4th Case No. Plaintiff Request for Order for Disclosure Minn. Stat. §§491A.02, subd. 9, 550.011 Defendant TO: The Court Administrator Concerning: Judgment Debtor’s Name Address City/State Zip The Judgment Creditor states that: 1. The Judgment Creditor has won a Judgment in this lawsuit against the Judgment Debtor. 2. The case began in District Court and the Court Administrator docketed the judgment more than thirty (30) days ago OR the case began in Conciliation Court and the Court Administrator has docketed the judgment; 3. The Judgment Debtor has not paid all of the money which is owed to the Judgment Creditor, and 4. The Judgment Creditor and the Judgment Debtor have not agreed to some other way to settle the debt. The Judgment Creditor requests that the Court order the Judgment Debtor to fill out a Financial Disclosure form, and mail it to the Judgment Creditor at the address shown below. The statements made in this request are true and correct to the best of my knowledge. Date: Judgment Creditor’s Authorized signature and title Print Judgment Creditor’s Name Address City/State Zip Telephone Form Order for Disclosure Request Page 1 of 1 Approved Conference of Chief Judges: (SCAO 8/1996) Revised: 8/3/2004 American LegalNet, Inc. www.FormsWorkflow.com