HSMV 74038 (Rev06/13)
SATISFACTION OF JUDGMENT FORM
STATE OF FLORIDA, DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
SUSPENDED DRIVER’S PERSONAL INFORMATION (DEFENDANT/DEBTOR)
PLEASE PRINT:
Last Name
First Name
Middle Initial
Suffix
FR Case Number
Date of Birth
Driver’s License Number
Social Security Number
Date of Crash
County
Date of Judgment
Amount
Court Case #
COMPLETE FOR SATISFACTION:
Law Office Name
Law Office Address
Telephone Number
Email Address
BY SIGNING THIS FORM BELOW, I ACKNOWLEDGE FULL PAYMENT AND SATISFACTION OF THE ABOVE JUDGMENT RENDERED BY THE ABOVE
LISTED COURT. NOTE: ONE FORM PER DEFENDANT
Attorney’s Signature
Date
Attorney’s Name
Plaintiff’s Name
Date of Satisfaction
NOTARY:
State of:
County of:
The foregoing instrument was acknowledged before me this day of _____,20_________ by ____________________________________________,
Who is personally known to me or who has produced a/an _______________________________________and who did (did not) take an oath.
Name of Notary _______________________________________________________
Affix Seal Here Notary Public Signature_________________________________________________
NOTE: FORM MUST BE MAILED OR FAXED DIRECTLY FROM THE ATTORNEY’S OFFICE. IF FORM IS PROVIDED TO THE
DEFENDANT, IT REQUIRES NOTARIZATION.
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