HOW TO COMPLETE THE ENDORSEMENT FORM TO TRANSFER A CERTIFICATE by country

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									         HOW TO COMPLETE THE ENDORSEMENT FORM TO TRANSFER A CERTIFICATE
                                  (revised 8/2007)

1. When mailing the endorsement form(s): The form(s) must be notarized, the fee is $2.25 per each
   certificate being transferred. Money must accompany the form and must be in guaranteed funds (i.e.,
   money order, cashier’s check, certified check). Mail to Brevard County Tax Collector, Attn: Delinquent
   Tax Department, P.O. Box 2500, Titusville, FL 32781
2. When hand delivering the endorsement form(s): If the form(s) is not notarized, the endorsement
   form(s) must be signed by the transferor in front of a Tax Collector Employee, the fee is $4.50 per each
   certificate being transferred. Money must accompany the form and is required in guaranteed funds (i.e.,
   money order, cashier’s check, certified check). Notarized endorsement forms and transfer fees can also
   be hand delivered to the Tax Collector’s Office.
3. You can have multiple tax certificates of the same year on one form. Example: You can put 2004
   certificates on one form and the 2005 certificates on another form. The fee remains per certificate, not per
   form.
4. New certificate holders are required to submit a completed W-9 Form with the Endorsement Form.
5. The W-9 Form and the Endorsement Form must be dated in the same month and received at the same
   time in the same envelope.

                                        SAMPLE COMPLETED ENDORSEMENT FORM

                                                      ROD NORTHCUTT, C.F.C., C.P.M.
                                                    TAX COLLECTOR, BREVARD COUNTY

                                                              ENDORSEMENT FORM

 I, _(Enter Certificate Holder Name as Registered with this Office)_, the Transferor/Owner of the Certificate(s) listed below, hereby transfer all my
 rights, title, and interest in and to the following tax certificate(s):

 Certificate Number                            Tax Account Number                         Parcel I.D. Number
 _(ex. 2004-1111)____                          _(ex. 2222222)_____                _(ex. 22 22 22 2222 22) ________
 _(ex. 2004-2222)____                          _(ex. 3333333)_____                _(ex. 33 33 33 3333 33) ________
 __________________                            _________________                  ____________________________

 To:___(Enter the New Certificate Holders Name as Registered with this Office) _______________________________________________

 Dated this ____________________ day of ____(Enter the Date of Transfer)____________________________, _____________________.

                                                                                                         _(Certificate Holder Must Sign) ____
                                                                                                         Signature of Transferor

                                                                                                         _(If Applicable)_________________
                                                                                                         Title
 Endorsement must be acknowledged before the Tax Collector or a notary public.

                                                     ACKNOWLEDGEMENT
                         (THIS SECTION TO BE COMPLETED BY NOTARY OR SIGNED BY TAX COLLECTOR EMPLOYEE)

 STATE OF _____________________________
 COUNTY OF ___________________________

 I HEREBY CERTIFY that on this day before me personally appeared _________________________________
 to me known to be the person described in the foregoing tax certificate(s), which person acknowledged before me that he executed the foregoing
 endorsement. WITNESS my hand and official seal this ___________________________ day of _____________________________,
 __________________________ .
                                                                               _______________________________(Seal)
                                                                               Tax Collector
                                                       OR
                                                                               ____________________________________________
                                                                               Notary Public Signature
                                                                                  My Commissioner Expires :

 NOTE: The Tax Collector’s Office must be notified of the change of ownership and the applicable fees paid. New certificate holders must provide/complete
 a W-9 form.

 TC-181 (Revised 8/07)

								
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