CASE NUMBER:
CASE NUMBER: _________________________ JEFFERSON CIRCUIT COURT
DIVISION ___________
______________________________________________
______________________________________________
v. STATEMENT OF AMOUNT TO BE RAISED (JRP 502D)
______________________________________________
______________________________________________
Property Address: _____________________________________________________________
|Default Date: | |
|Principal plus any additional amounts | |
|sought in judgment | |
|Interest Rate: | |
|Other payoffs: *MSD lien & other lien- | |
|holders who have obtained a judgment | |
|Per Diem Rate: | |
|(=Principal * Interest Rate / 365) | |
|Amount To Be Raised (Amounts sought | |
|in judgment plus other payoffs) |$ |
The above amounts are submitted by the moving party, _____________________________. The undersigned certifies that the above information is correct, and all parties of record on the attached list have been served with notice of this pleading on ______________________.
__________________________________________
Attorney’s Signature
_(Type Name)______________________________
_(Type Address)____________________________
__________________________________________
Phone Number
Revised 1/4/2013
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