Clerk of the Circuit Court, Brevard County, Florida
Tax Deed Department, P.O. Box 219, Titusville, Florida 32781-0219
Telephone: (321) 637-2007 ∙ www.brevardclerk.us
Scott Ellis, Clerk
INFORMATION REGARDING MAKING A CLAIM TO RECEIVE SURPLUS
PROCEEDS OF A TAX DEED SALE
FAILURE TO INCLUDE ANY OF THE DOCUMENTATION LISTED BELOW MAY
DELAY YOUR CLAIM AND MAY RESULT IN DISBURSEMENT NOT BEING MADE
TO YOU. IT IS INCUMBENT ON A CLAIMANT TO PROVIDE CORRECT AND
COMPLETE INFORMATION IN ORDER TO FACILITATE REVIEW OF CLAIMS AND
DISBURSEMENT.
Individual Claims
If you are submitting a claim, please make sure you have included the following
documentation:
A completed and notarized statement of claim;
A completed (signed and dated) W-9 form;
A photocopy of two forms of government-issued identification (i.e. a driver’s
license, passport, state I.D. card, etc.).
Claims of Heirs or Assignees
In addition to the items listed above, you will also need to provide the following:
A certified copy of Letters of Administration that are current and in full force
and effect;
A certified copy of a court order disbursing the funds to you; and
A fully executed assignment of interest, if claiming as an assignee.
Claims of Lienholders
In addition to the items listed for Individual Claims, you will need to provide:
A current accounting or ledger of total amount owned to you as a lienor; and
A completed (signed and dated) W-9 form.
All claims will be processed according to section 197.582, Florida Statutes.
Upon verification of a claim, disbursement will be made within two weeks. Additional
information may be required from a claimant to verify a claim, and the Clerk may need
to institute legal action to determine priority of claims. If you have any questions prior to
submitting your claim, please contact the Tax Deed Department at (321) 637-2007 or
taxdeedclerks@brevardclerk.us.
NOTICE OF TAX DEED SALE SURPLUS
Clerk of the Circuit Court, Brevard County, Florida
Tax Deed Department, P.O. Box 219, Titusville, Florida 32781-0219
Telephone: (321) 637-2007 www.brevardclerk.us
Scott Ellis, Clerk
Pursuant to Chapter 197, Florida Statutes, the above property was sold at public sale on
________________, and a surplus of ______________________ (subject to change) will be held by
this office for 120 days beginning on the date of this notice to benefit the persons having an
interest in this property as described in section 197.504(4), Florida Statutes, as their interests may
appear (except for those persons described in section 197.504(4)(h), Florida Statutes).
To the extent possible, these funds will be used to satisfy in full each claimant with a senior
mortgage or lien in the property before distribution of any funds to any junior mortgage or lien
claimant or to the former property owner. To be considered for funds when they are
distributed, you must file a notarized statement of claim with this office within 120 days of this
notice. If you are a lienholder, your claim must include the particulars of your lien and the
amounts currently due. Any lienholder claim that is not filed within the 120-day deadline is barred.
A copy of this notice must be attached to your statement of claim. After the office
examines the filed claim statements, it will notify you if you are entitled to any payment.
Dated: _____________
Tax
Deed
File No: __________________________
Certi
fi
cate
N
o:
____________________________
LEGAL
D
ESCRIPTION
______________________________________________
______________________________________________
______________________________________________
______________________________________________
SCOTT ELLIS
BREVARD COUNTY CLERK OF COURT
By: ___________________________________
Deputy Clerk (SEAL)
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Clerk of the Circuit Court, Brevard County, Florida
Tax Deed Department, P.O. Box 219, Titusville, Florida 32781-0219
Telephone: (321) 637-2007 www.brevardclerk.us
Scott Ellis, Clerk
Complete and return to:
Brevard County Clerk of the Circuit Court
Tax Deed Department
P.O. Box 219, Titusville, Florida 32781-0219
taxdeedclerks@brevardclerk.us
CLAIM TO RECEIVE SURPLUS PROCEEDS OF A TAX DEED SALE
Note: The Clerk of the Court must pay all valid liens before distributing surplus funds to a titleholder.
Claimant’s name: ____________________________________________________________________________
Contact name, if
applicable: ____________________________________________________________________________
Address: ____________________________________________________________________________
Telephone No.: ____________________________________________________________________________
Email Address: ____________________________________________________________________________
Tax Deed No.: ____________________________________________________________________________
I am not making a claim I claim surplus proceeds I am a (check one):
and waive any claim I might resulting from the above tax Lienholder Titleholder
have to the surplus funds on deed sale.
this tax deed sale.
LIENHOLDER INFORMATION
(Complete if claim is based on a lien against the sold property)
Type: Mortgage Court Judgment Other (describe) ___________________________________
If your lien is recorded in the County’s Official Records, list the following, if known:
Recording Date: ____________ Instrument #: ___________________ Book: __________ Page: __________
Original Amount of Lien: $ ________________________ Amounts Due: $ __________________________
Principal remaining due: $ _______________________ Interest Due: $ _________________________
Fees and costs due, including late fees: $ ____________________ Attorney Fees: $ ___________________
TITLEHOLDER INFORMATION
(Complete if claim is based on title held on sold property)
Nature of title: Deed Court Judgment Other (describe) ______________________________________
If your former title is recorded in the County’s Official Records, list the following, if known:
Recording Date: _____________ Instrument #: ___________________ Book: __________ Page: __________
Amount of surplus tax deed sale proceeds claimed: $ _______________________________________________
VERIFICATION OF CLAIM TO RECEIVE
SURPLUS PROCEEDS OF A TAX DEED SALE
I hereby swear or affirm that all of the above information is true and correct.
__________________________
Date
___________________________________
Signature of Claimant
STATE OF
COUNTY OF ____________________
Sworn to or affirmed and signed before me on the _________ day of __________________________, 20_______,
by ______________________________, who is personally known produced _________________________ as
identification.
___________________________________
Signature of Notary Public/Deputy Clerk
( S E A L )
___________________________________
Printed Name of Notary Public/Deputy Clerk
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