DWIGHT D. SULLIVAN COUNTY CLERK GALVESTON COUNTY REQUEST FOR ABSTRACT OF JUDGMENT Please process this request to have Judgment against the Defendant/Respondent abstracted. The information below is to be stated on the abstract. Date: Cause Number: Court: Galveston County Court at Law No. Style: Vs. JUDGMENT CREDITOR INFORMATION: Name of Judgment Creditor in Judgment: Judgment Creditor Address: JUDGMENT DEBTOR INFORMATION: Name of Judgment Debtor in Judgment: Judgment Debtor222s Address: Judgment Debtor DOB: Last three numbers of Driver222s License No.: Last four numbers of Social Security No.: JUDGMENT INFORMATION: Date of Judgment: Amount of Judgment: Post Judgment Interest Rate: Attorney222s Fees: Amount of Costs: Amount of Credits: Balance Due on Judgment: REQUESTED BY: Attorney or Judgment Creditor Name: Address: Hold for Pickup Return by Mail SIGNATURE OF PERSON REQUESTING ABSTRACT: Please return this request along with $5 fee to Dwight D. Sullivan, County Clerk American LegalNet, Inc. www.FormsWorkFlow.com