ORS 18.170 Form for lien record abstract; rules

Unless otherwise prescribed by law, a person recording a lien record abstract shall use substantially the following form: __________________________________________

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

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. The final four digits of the debtor’s Taxpayer Identification No., or the final four digits of the debtor’s Social Security No. (if known): 4. The final four digits of the 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: __________________________________________

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.