CIV_OwnersClaimforMortgageForeclosureSurplus(County)_20210602_WEB Page 1 of 2
IN THE COUNTY COURT, IN AND FOR MARION COUNTY, FLORIDA
Case Number:
Plaintiff
vs.
Defendant
OWNERS CLAIM FOR MORTGAGE FORECLOSURE SURPLUS
Under penalty of perjury, I (we) hereby certify that:
1. I was (we were) the owner of the following described real property in Marion County,
Florida, prior to the foreclosure sale and as of the date of the filing of the lis pendens:
2. I (we) do not owe any money on any mortgage on the property that was foreclosed other
than the one that was paid off by the foreclosure.
3. I (we) do not owe any money that is the subject of an unpaid judgment, condominium
lien, cooperative lien, or homeowners= association.
4. I am (we are) not currently in bankruptcy.
5. I (we) have not sold or assigned my (our) right to the mortgage surplus.
6. My (our) new address is: .
7. If there is more than one owner entitled to the surplus, we have agreed that the surplus
should be paid jointly or to: at the following
address: .
8. I (WE) UNDERSTAND THAT I (WE) AM (ARE) NOT REQUIRED TO HAVE A
LAWYER OR ANY OTHER REPRESENTATION AND I (WE) DO NOT HAVE TO
ASSIGN MY (OUR) RIGHTS TO ANYONE ELSE IN ORDER TO CLAIM ANY
MONEY TO WHICH I (WE) MAY BE ENTITLED.
CIV_OwnersClaimforMortgageForeclosureSurplus(County)_20210602_WEB Page 2 of 2
9. I (WE) UNDERSTAND THAT THIS STATEMENT IS GIVEN UNDER OATH, AND
IF ANY STATEMENTS ARE UNTRUE THAT I (WE) MAY BE PROSECUTED
CRIMINALLY FOR PERJURY.
Owner(s) signature
Owner(s) signature
STATE OF FLORIDA
COUNTY OF ___________________
_______________ ___ .
__________________________________________
Signature and Title of Notary Public or Deputy
Clerk
__________________________________________
____________________________
Sworn to (or affirmed) and subscribed before me by means of physical presence or online
notarization, this ______ day of , 20 by ___________________________
(Print, type, or stamp commissioned name of
Notary Public)
Personally Known OR Produced Identification
Type of Identification Produced:
