Simply replace the unfilled areas such as "__" and "_[date]_" with your information.
Dear [name of clerk],
Attached please find [number of copies] copies of [name of legal pleading] which we would like to file on record for case number [docket number], [name of case].
We have also included a check in the amount of [amount of check] to cover filing fees and service cost related to this pleading.
Please file this pleading into the record and process it accordingly. Please provide us with a certified copy via United States Postal Mail. The fee enclosed is sufficient to cover copying and certification fees.
Thank you for your attention to this matter.