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- 1 - STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No. , Petitioner, SATISFACTION OF JUDGMENT AND , Respondent, The above-named Plaintiff, ___________________, hereby certifies that the judgment entered and docketed in the Court above-named in the action above-entitled on the __________ day of __________, 20__, in favor of the Plaintiff against the above-named Defendant, ___________________ , for the sum of ____________________ and __________ Dollars ($ __________ ) has been paid and satisfied in full; and that the Court Administrator is he reby authorized to discharge said judgment of record. IN TESTIMONY WHEREOF, ___________________, President of ___________________ , has hereunto set his hand this __________ day of __________, 20___. ____________________________ ATTORNEY AT LAW - 2 - STATE OF MINNESOTA) )SS. COUNTY OF ___________) On this ___________ day of _____________, 20___, before me personally appeared ___________, President of ___________, the above-named Plaintiff, to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he execute d the same as his/her free act and deed. Dated: Petitioner/Respondent Subscribed and sworn to before me this _____ day of ____________, 20___. ______________________________ NOTARY PUBLIC - 3 - STATE OF MINNESOTA DISTRICT COURT COUNTY OF JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No. , Petitioner, SATISFACTION OF JUDGMENT AND , Respondent, _________________, Plaintiff above-named, hereby certifies that the judgment entered and docketed in the Court above-named in the action above-entitled on the ___ day of _____________, 20___ , in favor of the Plaintiff against the above-named Defendant, _________________, for the sum of _________________ and _________________ Dollars ($_________________ ) has been paid and satisfied in full; and that the Court Administrator is hereby authorize d to discharge said judgment of record. IN TESTIMONY WHEREOF, _________________, President of _________________ , has hereunto set h is/her hand this _____ day of _________________, 20__ . - 4 - STATE OF MINNESOTA) )SS. COUNTY OF ___________) Dated: Petitioner/Respondent Subscribed and sworn to before me this _________ day of _________ , 20_________ . ______________________________ NOTARY PUBLIC

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Fill and Sign the above Named Plaintiff Hereby Certifies that the Judgment Form