Reset Form
DTE 122A
Rev. 3/11
Request for Foreclosure
Pursuant to Ohio Revised Code 5721.37, I,
, hereby fi le a request for a
foreclosure action with the
County Treasurer on the following tax certifi cate on this date
,
.
Tax certifi cate number
Lien year(s)
Parcel owner
Property address
Tax certifi cate sale date
The above certifi cate holder has submitted the following required monies and fees associated with this foreclosure request:
1. Certifi cate redemption prices of any other tax certifi cates sold on the parcel, other
than tax certifi cates held by the certifi cate holder fi ling this form (certifi cates listed
separately on other side) .................................................................................................. $
2. Taxes, assessments, penalties, interest, and charges that are not covered by a
tax certifi cate (itemized listing on other side) ................................................................... $
3. Foreclosure fee prescribed by the county prosecutor ...................................................... $
4. Total paid on this date ...................................................................................................... $
Signature
Tax certifi cate holder
I hereby certify that the above certifi cate parcel has not been redeemed, the amount indicated in line 4 has been received
by me and the certifi cate holder has made a request for foreclosure, which I have submitted to the county prosecutor to
commence foreclosure proceedings on this date:
,
.
Signature
Treasurer/designee