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Limited Judgment For Deferred Fees With Money Award Form. This is a Oregon form and can be use in Circuit Court Statewide.
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Tags: Limited Judgment For Deferred Fees With Money Award, Oregon Statewide, Circuit Court
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF _____________________
______________________________________,
Petitioner/Plaintiff,
v.
______________________________________,
Respondent/Defendant.
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Case No. _________________
LIMITED JUDGMENT
SUPPLEMENTAL JUDGMENT
FOR DEFERRED FEES WITH
MONEY AWARD
_______________________________________ (applicant name) has filed an application for deferral of
fees. The court has reviewed the application and deferred all or part of the fees. As of the date of this
judgment, the amount shown below is unpaid and the applicant is obligated to the State of Oregon for that
amount.
MONEY AWARD
Judgment Creditor: State of Oregon
___________________________________________________________________
Address
City
State
Zip
Judgment Debtor: ___________________________________________________________________
Full Name
Social Security Number
Driver License # / State
___________________________________________________________________
Address
City
State
Zip
___________________________________________________________________
Name of Attorney (if represented by counsel)
Bar Number
Attorney Phone Number
___________________________________________________________________
Attorney Address
City
Filing Fee(s) $__________
Hearing Fee(s) $________
Motion Fee(s) $_________
Zip
Trial Fee(s) $_______________
Other Fee(s) $______________
TOTAL DUE $_________
State
Interest Rate __0__%
To be paid in full by (date) _____________.
To be paid according to a collection agreement.
To be paid according to a payment schedule of $_______ today and $_______ on the same day of each
month until paid.
_______________________________
__________________________________________
Date
Signature of Judge/Court Administrator
__________________________________________
Name of Judge/Court Administrator (printed or typed)
Limited or Supplemental Judgment for Deferred Fees with Money Award
OJIN Code: JGLN (Judgment Limited Creates Lien) or JGSK (Judgment Supplemental Creates Lien)
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NOTICE
When you are granted a partial or full deferral of fees, the deferred fees are an obligation owed by you to
the State of Oregon. This obligation is payable according to the terms set out above. Failure to pay the
amount shown within 30 days of entry of the judgment or failure to comply with the payment schedule may
result in 1) additional amounts for administrative and collection costs to be added automatically to the
judgment, and 2) your account being referred to the Department of Revenue for collection, without further
notice to you from the court. When payment is received in full, the court will make a notation in the court
records.
Checks or money orders are to be made payable to the State of Oregon and may be mailed to the
following address:
_____________________________________
Court Name
_____________________________________
Mailing Address
_____________________________________
City
State
Zip
Cash or credit/debit card payment must be brought to the address below:
_____________________________________
Court Name
_____________________________________
Street Address
_____________________________________
City
State
Zip
Limited or Supplemental Judgment for Deferred Fees with Money Award
OJIN Code: JGLN (Judgment Limited Creates Lien) or JGSK (Judgment Supplemental Creates Lien)
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