N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. IX, form UCS-121
UCS 121 (Rev. 11/90)
Transcript of Judgment
Index No. ________
State of New York, ________ Court of ________, County of ________
Type of proceeding: Civil________Summary ________ Small Claim________Commercial Claim ________Commercial Claim (Consumer Transaction________
1) ________ 1) ________
2) ________ vs 2) ________
3) ________ 3) ________
4) ________ 4) ________
First Paper filed ____________ Notice of Trial filed ____________
Jury ________ Waived ________ Demanded by ________
Amount sued for ________ Arbitration ________ Non-Arbitration ________
Disposition ____________
____________
Date of disposition ____________ Date of Appeal ____________
Attorney for Plaintiff Attorney for Defendant
Name ____________ Name ____________
Address ____________ Address ____________
____________ ____________
Phone No. ____________ Phone No. ____________
Remarks ____________
____________
Trade or profession of Judgment Debtor ____________
Last known address of Judgment Debtor ____________
Address of Judgment Creditor ____________
Terms ____________
____________
$____________, plus $____________ Court Costs = $____________
Judgment rendered ________ (date)
Judgment docketed ________ (date) ____________ hr. and min.
Clerk's signature ____________ (date) ________
Execution issued on ____________ Return satisfied on ____________
____________
Remarks (date and manner of change of status of judgment ____________
____________
____________
____________
State of New York
County of ________
(seal)
I, ________ (Clerk, Judge or Justice) of the court named above, hereby certify that the above is a correct transcript from the docket of judgment in my office.
Satisfaction of Judgment on ________. Indicate how and to what to extent ____________
Clerk's Signature ____________ (date) ________
N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. IX, form UCS-121