IN THE COURT, EIGHTEENTH JUDICIAL CIRCUIT, BREVARD COUNTY, FLORIDA DIVISION: CIVIL PLAINTIFF CASE NUMBER CLOCK IN 05 - - - - XXXX-XX CITY / STATE / ZIP ADDRESS TELEPHONE NUMBER DEFENDANT MOTION FOR ENTRY OF DEFAULT BY CLERK The Petitioner/Plaintiff, ________________________________________, moves the Clerk to enter a Default against the Respondent/Defendant, _____________________________________________________________. (Signature of person submitting paper) Name Address City/State/Zip Telephone Number I HEREBY CERTIFY that a true and correct copy of the above paper has been furnished by hand delivery telefax U. S. Mail courier to ____________________________________________________ at ____________________________________________________, this ______ day of ____________, 20 ___. Signature of Petitioner/Respondent Law 580 Rev. 12-17-2012 BAR CODE LABEL American LegalNet, Inc. www.FormsWorkFlow.com