Fillable CLAIM TO SURPLUS PROCEEDS OF A TAX DEED

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CLAIM TO SURPLUS PROCEEDS OF A TAX DEED

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Revised 5/22/2018
CLAIM TO SURPLUS PROCEEDS OF A TAX DEED SALE
Complete and return to
Alachua County Clerk of Court
Attn: Tax Deeds
201 E University Avenue,
Gainesville FL 32601
Note: The Clerk must pay all valid liens before distributing to a titleholder
Claimant’s name*
Contact name if claimant is not an individual
Address**
St
Zip
Phone no.
Email address
Tax deed no.
Date of sale (if known)
I am not making a claim and waive any claim I might have to the surplus funds on this tax deed sale.
I claim surplus proceeds resulting from the above tax deed sale. I am a ____ Lienholder ____ Titleholder.
1. LIENHOLDER INFORMATION (Complete if claim is based on a lien against the sold property.)
(a) Type of Lien:
Mortgage; Court Judgment; Condo or Homeowner Association Lien; Other
Describe in Detail:________________________________________________________________________
If your lien is recorded in Alachua County’s Official Records, list the following, if known:
Recording Date:
Instrument #:
Book/Page #:
_______ / _______
(b) Original Lien Amount:
$
Amount due:
$
Principal Remaining Due:
$
Interest Due:
$
Fees & Costs*
$
Attorney fees claimed:
$
*Including late fees. Describe costs in detail, including additional sheet if needed:
2. TITLEHOLDER INFORMATION (Complete if claim is based on title formerly held on sold property.)
(a) Nature of Title:
___Deed; ___Court Judgment; ___Other:___________________________________________
If your former title is recorded in _____________ County’s Official Records, list the following, if known:
Recording Date:
Instrument #:
Book/Page #:
________ / _________
Amount of surplus tax deed sale proceeds claimed:
$
Does the titleholder claim the subject property was homestead property?
___Yes ___No
3. I request that payment of any surplus funds due me be made payable to: _________________________ and
such payment be mailed to either the address above or to: ____________________________________.
4. I hereby swear that all of the above information is true and correct.
Date: _________________________ Signature: ___________________________________________
Claimant
STATE OF ________________
**NOTARIZATION NOT REQUIRED IF CLAIM IS BEING WAIVED**
COUNTY ________________
Sworn to or affirmed and signed before me on by ____________________________
.
NOTARY PUBLIC or DEPUTY CLERK
[Print, type, or stamp commissioned name of notary]
____ Personally known
____ Produced identification; Type of identification produced
____________
*This is the payee
INDIVIDUAL CLAIMANTS MUST PROVIDE A COPY OF THEIR GOVERNMENT ISSUED PHOTO ID
**This where payment will be mailed.
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CLAIM TO SURPLUS PROCEEDS OF A TAX DEED

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Completed 28 March 2022

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