Fill and Sign the Transcript and Form

Judgment Docket Book & Page File No. STATE OF NORTH CAROLINA In The General Court Of Justice District Superior Court Division Clerk Of Superior Court Assistant CSC Deputy CSC AM PM Clerk Of Superior Court Assistant CSC Deputy CSC Judgment was rendered in this action against the judgmen t debtor(s) indicated. I certify that the following is a correct transcript from the Judgment Docket in my office and the required miscella neous fee has been collected. To The Clerk Of Superior Court Of The County Named Belo w: County VERSUS TRANSCRIPT AND CERTIFICATION OF JUDGMENT G.S. 1-234 AOC-CV-403, Rev. 9/03 2003 Administrative Office of the Courts Signature Name Of County Where This Transcript Was Docketed Date Of Docketing Time Date File No. Judgment Docket Book And Page Name Of Plaintiff Name And Address Of Judgment Debtor 2 Name And Address Of Judgment Debtor 1 Name Of Defendant CERTIFICATION OF TRANSCRIPT OF JUDGMENT $ Amount Of Judgment CERTIFICATION OF FILING AND DOCKETING TRANSCRIPT OF JUDGMENT To The Clerk Of Superior Court Of The County In Which Transcripted Judgment Was Rendered: Signature Name Of County Where This Transcript Is To Be Docketed Date $ Rate Of Interest Court Costs Date From Which Interest Due Date Of Judgment Transcript No. I certify that the foregoing Transcript Of Judgment was filed and docketed in my office against the judgment debt or(s) indicated above as follows: Abstract No.