MEMORANDUM TO THE CLERK: DEPOSITING ORIGINAL DOCUMENTS
CASE NO.: 05 - _____ - ______ - _________ - ___XXX – XX
EPORTAL REFERENCE NO.: ___________________
DATE: ___________________________________
TO: Brevard County Clerk of the Circuit Court
FROM: ___________________________________
___________________________________
___________________________________
___________________________________
Please find enclosed the following original document(s) that is/are required to be
deposited with the Brevard County Clerk of the Circuit Court in its/their original form by
statute, rule, or SC11-399:
Original Note
Original Mortgage
Original Will
Original Codicil
Original Affidavit(s)/Sworn Document(s) (Criminal Division Only)
Other: __________________________________________________________
The document(s) indicated above has/have previously been filed through the ePortal in
the case number indicated above at www.myflcourtaccess.com and is/are being
forwarded to the Clerk for deposit only as required by statute, rule or SC11-399.
/s
Signature
Send completed form and document(s):
Scott Ellis
Brevard County Clerk of the Circuit Court
P.O. Box 219
Titusville, Florida 32781-0219
FOR CLERK’S INTERNAL USE ONLY
Box #: ________________________________
Record Series: _________________________
