Fillable Rachel M. Sadoff INFORMATION REGARDING MAKING A CLAIM (Brevard County Clerk, Florida)

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Rachel M. Sadoff INFORMATION REGARDING MAKING A CLAIM (Brevard County Clerk, Florida)

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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.
Rachel M. Sadoff
CLERK OF THE CIRCUIT COURT & COMPTROLLER
EIGHTEENTH JUDICIAL CIRCUIT
BREVARD COUNTY, FLORIDA
tax deed department
POST OFFICE BOX 219
TITUSV ILLE, FLORIDA 32781- 0219
MAIN (321) 637-5413
DEPARTMENT (321) 637-2007
WWW.BREVARDCLERK.US
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: $ _______________________________________________
Rachel M. Sadoff
CLERK OF THE CIRCUIT COURT & COMPTROLLER
EIGHTEENTH JUDICIAL CIRCUIT
BREVARD COUNTY, FLORIDA
tax deed department
POST OFFICE BOX 219
TITUSV ILLE, FLORIDA 32781- 0219
MAIN (321) 637-5413
DEPARTMENT (321) 637-2007
WWW.BREVARDCLERK.US
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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Rachel M. Sadoff INFORMATION REGARDING MAKING A CLAIM (Brevard County Clerk, Florida)

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Completed 11 October 2021

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