Fillable Tax Sale Overage Claim Form printable pdf download

CLAIM FOR TAX SALE OVERAGE

PLEASE PROVIDE THE FOLLOWING INFORMATION:

Tax Sale Year: ____________________ Item Number: ____________________Tax Map Number: _______________________

______________________________________________________________________________________________________

Name of Defaulting Taxpayer

______________________________________________________________________________________________________

Location of Property

Owner(s) of Record Prior to End of Redemption Period:

__________________________________________________ ___________________________________________________

Name

Address

__________________________________________________ ___________________________________________________

Name

Address

Mortgage or Lien Holder(s) of Record Prior to End of Redemption Period:

__________________________________________________ ___________________________________________________

Name

Address

__________________________________________________ ___________________________________________________

Name

Address

STATE OF SOUTH CAROLINA

COUNTY OF LAURENS

PERSONALLY appeared the undersigned, who being sworn, say (s) that this claim is pursuant to Section 12-51-130 for the

overage produced by a delinquent tax sale. The tax sale is described in the deed from the Tax Collector to the highest bidder,

recorded in Deed Book________, Page________, in the Register of Deeds Office for Laurens County, a copy of which is

attached to this claim. The amount over the full amount due in taxes, assessments, penalties and costs, produced by the tax

sale as shown by the Tax Collector at the bottom of this claim form is the amount lawfully owing to the undersigned. A copy of

the deed or of the probate conveyance sheet showing the ownership in the undersigned is attached to verify to whom the refund

check should be made payable. The undersigned has been authorized to receive the refund check on behalf of all. The

undersigned indemnifies and holds Laurens County, its agents and employees harmless against claims by any other persons for

such overage and waives all causes of action against the County, its agents or employees, arising out of the tax sale. The

undersigned attaches a copy of the Social Security card of the undersigned and such other identification, as the Tax Collector

shall request.

__________________________________________________ ___________________________________________________

Signature of Claimant 1

Claimant 1 (Printed)

__________________________________________________ ___________________________________________________

Signature of Claimant 2

Claimant 2 (Printed)

SWORN to before me this ______ day of ___________, 20___.

_____________________________________________ (SEAL)

Notary Public for the State of ______________________

My Commission Expires: _________________________

For Delinquent Tax Office Use Only:

Overage Amount: $___________________________ Check Date: _________________________ Check Number: ___________________________________

Check made payable to: ____________________________________________________________________________________________________________

The following documents are attached:

Comments: _________________________________________________

__________ Deed from Tax Collector to Successful Bidder

_________________________________________________

__________ Deed by which Claimant(s) Acquired Property

__________ Social Security Card(s) of ALL Claimants

_________________________________________________

__________ Picture ID of ALL Claimants

Tax Sale Overage Claim Form

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