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E full title of the case. 2. Enter the case number. 3. Enter the judgment debtor s complete name, occupation, place of residence and post office address. Note: If debtor lives in an incorporated place of more than 5,000, the street and number of both residence and business must be given. 4. The judgment creditor, creditor s agent or attorney must list their name, address, telephone number and attorney ID number if appropriate. 5. Sign the form before a Notary Public or before a Henne.

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