Unclaimed Property Tax Refund Claim Form

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TREASURER-TAX COLLECTOR
COUNTY OF SAN DIEGO
COUNTY ADMINISTRATION CENTER • 1600 PACIFIC HIGHWAY, ROOM 162
SAN DIEGO, CALIFORNIA 92101-2477 • (877) 829-4732 • FAX (619) 531-6056
web site:
DAN McALLISTER
Treasurer-Tax Collector
UNCLAIMED PROPERTY TAX REFUND CLAIM FORM
If you have made an overpayment of property taxes and wish to claim a refund, please complete this claim form and return it
to
the
County Tax Collector's office at the address below. Refund claims will be verified and, if valid,
refunds
are generally issued
within 4 to 6
weeks
after
receipt
of
the claim.
NAME:
PARCEL/BILL
NUMBER:
MAIL TO ADDRESS:
CITY:
STATE:
ZIP:
PHONE NUMBER:
EMAIL ADDRESS:
GROUNDS UPON WHICH THE CLAIM
IS
BASED:
Please
state
the
grounds
upon which you are claiming the refund and attach all
required
identification and supporting
documentation to your claim. Please
refer
to
the
attached
instructions for further details.
Failure to provide the required
documents
may result in the claim being denied and returned to
the
sender.
As a result, claimants are requested to provide
as
much information as possible in order
to
expedite our
review
process and to
substantiate the
claimant's right to the unclaimed
refund.
I state that I am the rightful claimant to the overpayment of taxes made on the above-referenced parcel/bill number. I certify
(or
declare) under penalty of perjury that
the
foregoing is true and correct. Furthermore,
I
agree
to indemnify
and hold
harmless
the
County of San Diego, its officers, and
its
employees from any loss resulting from the payment of this claim.
NOTE: YOUR SIGNATURE(S)
MUST
BE NOTARIZED IF THE REFUND IS OVER $500.
_____________________________________________
_________________________________________________
Signature of Claimant
Date
At (City or Town)
_____________________________________________
_________________________________________________
Printed Name
Title & Company (if applicable)
(Seal)
A notary public or other officer completing this certificate
verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the
truthfulness, accuracy, or validity of that
State of California
County of ___________________________
Subscribed and sworn to (or affirmed) before me on this ________ day of _________, 20_____, by
,
proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
______________________________________________________
Signature

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