Form WCT-5 "Affidavit Form D - Questions and Affidavit for Claimant Regarding Due Diligence in Enforcing the Judgment" - Missouri

What Is Form WCT-5?

This is a legal form that was released by the Missouri Department of Labor and Industrial Relations - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2012;
  • The latest edition provided by the Missouri Department of Labor and Industrial Relations;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form WCT-5 by clicking the link below or browse more documents and templates provided by the Missouri Department of Labor and Industrial Relations.

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Download Form WCT-5 "Affidavit Form D - Questions and Affidavit for Claimant Regarding Due Diligence in Enforcing the Judgment" - Missouri

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MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS
3315 West Truman Blvd., P.O. Box 58
TORT VICTIMS’ COMPENSATION
Jefferson City, MO 65102-0058
573-751-4231
QUESTIONS AND AFFIDAVIT FOR CLAIMANT
www.labor.mo.gov/DWC
REGARDING DUE DILIGENCE IN ENFORCING THE
JUDGMENT – AFFIDAVIT FORM D
File No:
Claimant’s Name:
(Please type or print your answers. You may use additional sheets if necessary.)
I,
, as part of my claim against the Missouri Tort Victims’
(name of undersigned claimant)
Compensation Fund, hereby answer the following questions truly, accurately and completely.
1. Have you obtained a final judgment against the tortfeasor?
Yes
No
Comment:
If no, do not continue with this form. Instead, complete Form WCT-4, Questions and Affidavit for Claimant
Regarding Waiver of Final Judgment Requirement – Affidavit Form C.
2. What was the date the judgment became final?
3. What efforts have been made by you or on your behalf to enforce or collect upon the final judgment? Answer in
detail, including dates.
Attach copies of all documents evidencing attempts at execution, attachment, garnishment, sequestration, results of
asset searches, and other similar documents.
Oath or affirmation. I,
, under oath or affirmation,
(print name)
state that the foregoing answers, statements and representations are true and correct to my best knowledge and belief,
subject to the penalties of making a false affidavit or declaration.
Signature
WCT-5 (04-12) AI
MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS
3315 West Truman Blvd., P.O. Box 58
TORT VICTIMS’ COMPENSATION
Jefferson City, MO 65102-0058
573-751-4231
QUESTIONS AND AFFIDAVIT FOR CLAIMANT
www.labor.mo.gov/DWC
REGARDING DUE DILIGENCE IN ENFORCING THE
JUDGMENT – AFFIDAVIT FORM D
File No:
Claimant’s Name:
(Please type or print your answers. You may use additional sheets if necessary.)
I,
, as part of my claim against the Missouri Tort Victims’
(name of undersigned claimant)
Compensation Fund, hereby answer the following questions truly, accurately and completely.
1. Have you obtained a final judgment against the tortfeasor?
Yes
No
Comment:
If no, do not continue with this form. Instead, complete Form WCT-4, Questions and Affidavit for Claimant
Regarding Waiver of Final Judgment Requirement – Affidavit Form C.
2. What was the date the judgment became final?
3. What efforts have been made by you or on your behalf to enforce or collect upon the final judgment? Answer in
detail, including dates.
Attach copies of all documents evidencing attempts at execution, attachment, garnishment, sequestration, results of
asset searches, and other similar documents.
Oath or affirmation. I,
, under oath or affirmation,
(print name)
state that the foregoing answers, statements and representations are true and correct to my best knowledge and belief,
subject to the penalties of making a false affidavit or declaration.
Signature
WCT-5 (04-12) AI