v.                                                                                 UCN:

                                                                                    Case No.                                








I hereby certify the following: 

Plaintiff’s Status: 



________(initial) Plaintiff is the original mortgagee and holds original note and:


                 _________(initial) Has previously filed, or is simultaneously filing with this certification, the original note with the Clerk.


_________(initial) Will file the original note with the foreclosure judgment packet.



________(initial) Plaintiff holds the note and rights there under through assignment, the name of the original lender is __________________________________.



________(initial) Whether the plaintiff is the original mortgagee or holds the note through assignment, the original note has been lost or destroyed, and Plaintiff has filed an affidavit attesting to the same in the court file with the Clerk of Circuit Court on ______________________(date).  (A copy of the lost note must be attached to the affidavit).


Borrower’s/Defendant’s Status:


_________  (initial & yes/no) The property which is the subject matter of this foreclosure is listed on the Public Records as subject to a Homestead Exemption for property tax purposes.


Using the following format provide the name of each borrower/defendant, the date and method of service of process on each defendant, and the current status of each defendant. If the property is listed as homestead for property tax exemption purposes, indicate if a copy of Attachments A and B to Administrative Order No. 2008-081 were provided to the borrower/defendants.


Name of Defendant


Date and method of service

[Date followed by personal, publication, or substitute]

Status of this Defendant

[Dropped; Default; Represented by (include name) of attorney; or, Filed pro se answer]

Owner/Defendant was provided with a copy of Attachment A & B at the time of service of process.


__/___/____ –_______





__/___/____ –_______





__/___/____ –_______





__/___/____ –_______





Using the following format provide the name of any borrower/defendant who has not answered or filed a motion to dismiss, and indicate whether an affidavit of non-military service or a memorandum for certificate of military service was filed with the clerk and the date of the document filing.  Do not include any borrower/defendant for whom the Clerk of Circuit Court has entered a default.



Name of Defendant

Indicate the type of document, i.e., Affidavit of non-military service (Affidavit) or memorandum of military service (Memo)

Date of filing with the Clerk of Circuit Court















Status of other required certifications:  I further certify of the following (Initial next to each completed item):


________ (initial) The Motion for Summary Judgment with copies of all supporting affidavits was sent by U.S. Mail to all Defendants on _________ (date) and filed with the Clerk of Circuit Court on ____________ (date). The following information is included in the supporting affidavits. (Note, these affidavits and amounts may be in the form of one document, but provide the amount claimed for each):




Amount claimed

Affidavit of Indebtedness/Amount Due* (see note below)



Affidavit of Attorney’s Time Expended



Affidavit as to Costs



Affidavit as to Reasonable Attorney’s Fees



* Note:  If the Plaintiff seeks a prepayment penalty, the affidavit of indebtedness must include reference to the specific clause in the loan contract that provides for a prepayment penalty in the event of foreclosure, and must specify the amount sought.  


_________ (initial) The proposed final judgment is, or at submission will be, in the form of the Sixth Judicial Circuit’s Uniform Final Judgment of Foreclosure and is in compliance with § 45.031, Florida Statutes.


_________ (initial) I have carefully reviewed this Certification of Compliance With Foreclosure Procedures and the supporting documents and I certify that the above styled matter is ready for hearing and summary judgment. 


_________ (initial) I certify that a true copy of the foregoing Certification of Compliance with Foreclosure Procedures has been furnished this _______ day of ________________, 20__, by facsimile or by regular U.S. Mail to the following:  (insert name of each defendant and include his or her address or facsimile number where the copy was furnished or specify the attachment containing that address or facsimile number).






I declare that I have read the foregoing Certification of Compliance with Foreclosure Procedures and the facts stated in it are true. 



                                                            Attorney Name


                                                            Direct telephone number:

                                                            Florida Bar No.