Excess Funds Claim Form

 

 

Owner name: ___________________________

Address:          ___________________________

                           ___________________________

                           ___________________________

 

 

The person listed above being sworn on oath, deposes and says as follows:

 

1.        This affidavit is being made and delivered to the Tax Commissioner of Cherokee County, Georgia as in inducement to cause said Tax Commissioner to pay over to the Affiant excess funds received in connection with the tax sale.

 

2.       That the claimant was the record title holder and owner of the property described herein at the time of tax sale and that the claimant is the correct person/party authorized to receive the excess funds.

 

3.       That there are NO liens, mortgages, deeds to secure debt, federal taxes, state taxes of any kind, pledges or other claims of any type, kind or variety against said property.

 

4.       That claimant has not transferred, conveyed or encumbered any of its rights or interest in the property described herein.

 

Signature of Affiant ______________________________________________________

Printed name of Affiant __________________________________________________

Relationship to title holder/owner of property ________________________________

 

Sworn to and subscribed before me this ______ day of ___________, ______.

Notary Public ____________________________

My commissioner expires __________________