Form 62a379 - Listing Of Omitted Real Property - 1998 Page 2

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SHERIFF’S OFFICIAL RECEIPT FOR OMITTED REAL PROPERTY TAX BILLS
I, _____________________________________________________ , Sheriff of ___________________________________ County,
hereby acknowledge receipt of _____________ omitted real property tax bills described below:
number
Tax Bill No.
Tax Year
Tax
Penalty
Interest
Total
_______________
____________
$ _________________
___________ ____________
$ ________________________
_______________
____________
$ _________________
___________ ____________
$ ________________________
_______________
____________
$ _________________
___________ ____________
$ ________________________
_______________
____________
$ _________________
___________ ____________
$ ________________________
_______________
____________
$ _________________
___________ ____________
$ ________________________
Signed_________________________________________________
Sheriff ________________________________________County
Signed and acknowledged before me this ____________________day of _________________ , 19______ .
___________________________________________________
Clerk __________________________________________County
CLERK’S CERTIFICATION
I, __________________________________________________ , Clerk of _____________________________________County, do
hereby certify that omitted tax bills have been prepared for all real property as listed on the reverse side of this form and certified by the
property valuation administrator for the years the property was omitted. I further certify that the total amount of tax, penalty and
interest due each taxing district represented by all bills prepared is as indicated above and that this certification and receipt is recorded
in County Order Book ___________ , Page ____________ .
Clerk __________________________________________County

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