(1) Unless otherwise prescribed by law, a person recording a lien record abstract shall use substantially the following form:
______________________________________________________________________________
LIEN RECORD ABSTRACT
The undersigned states:
A.Creditor/Prevailing Party Information:
__1. The creditor/prevailing party is:
_____________________
and the address of the creditor is:
_____________________
_____________________
under judgment, order or petition entered
on _____ (date) in the_____ Court for _____ (County) of _____ (State) under Case No._____.
__2.The Creditor’s attorney’s name is
_____________________
Attorney’s Address is:
_____________________
Attorney’s Phone No. is: ______
B.Debtor/Losing Party Information:
__1.The Debtor/losing party is:
_____________________
__2.Debtor’s address (if known):
_____________________
_____________________
__3.Debtor’s Social Security No. or
Taxpayer Identification No.
(if known):
_____________________
__4.Debtor’s driver license no. and
state of issuance for the license
(if known):
_____________________
__5.Name of debtor’s attorney
(if known):
_____________________
C.Judgment Information:
__1.The amount of the judgment is:
_____________________
__2.The amount of the costs is:
_____________________
__3.The amount of attorney fees, if any is:
_____________________
D.The Real or Personal Property to Be
Affected
(Check appropriate box):
__All real property of the debtor/losing party, now or hereafter acquired, in ________ County as provided under ORS 18.152.
__The following described real or personal property of debtor (legal description as set forth or on attached Exhibit):
_____________________
_____________________
_____________________
_____________________
IN WITNESS WHEREOF, the undersigned person or persons have executed this abstract this ___ day of ______, 2___.
________________________
________________________
State of Oregon)
)ss.
County of _____)
The foregoing instrument was acknowledged before me this ___ day of___, 2___, by ____________.
__________________
Notary Public for Oregon
My commission expires: _________
State of Oregon)
)ss.
County of _____)
The foregoing instrument was acknowledged before me this ___ day of ___, 2___, by ____________ and by ____________ of ____________, a corporation on behalf of the corporation.
__________________
Notary Public for Oregon
My commission expires: _________
______________________________________________________________________________
(2) A lien record abstract that is the result of a judgment for unpaid child or spousal support entered in another state shall be on the form prescribed by rules adopted by the Department of Justice in lieu of the form required by subsection (1) of this section. [Formerly 18.325]
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