REQUEST FOR ABSTRACT OF JUDGMENT DISTRICT CLERK, POTTER COUNTY, TEXAS (Instructions: COMPLETE this form, SIGN it, and MAIL it to: District Clerk, Potter County, P. O. Box 9570, Amarillo, TX 79105 CAUSE NUMBER: Date: Cause number must be provided Style of the Cause: I hereby request the District Clerk of Potter County to issue abstract/s of judgment in the above captioned cause and direct the Clerk to deliver the abstract/s as follows for recording: (check the appropriate blank) Return the abstract/s to the requestor for recording The Abstract of Judgment is recorded with the County Clerk. I have enclosed (circle one): a LAW FIRM CHECK, CASHIER'S CHECK or MONEY ORDER (no personal checks accepted) in the amount of: $_______8.00 per abstract $_______TOTAL ENCLOSED Signature of Requestor Address of Requestor Address of Respondent Legal Description of Property for Abstract American LegalNet, Inc. www.FormsWorkFlow.com