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OfficeOfTheTaxCommissioner
BethSoles
200CourthouseSquare/P.O.Box698@Woodbine,Georgia31569
Phone:(912)576-3248@Fax:(912)576-3496@E-mail:camdentc@co.camden.ga.us
OfficialClaimforExcessFunds
MapandParcelnumber
TaxSaleDate
Ownername:
Address:
Thepersonlistedabovebeingswornonoath,deposesandsaysasfollows:
1.ThisaffidavitisbeingmadeanddeliveredtotheTaxCommissionerofCamdenCounty,
GeorgiaasininducementtocausesaidTaxCommissionertopayovertotheAffiant
excessfundsreceivedinconnectionwiththetaxsale.
2.Thattheclaimantwastherecordtitleholderandownerofthepropertydescribedherein
atthetimeoftaxsaleandthattheclaimantisthecorrectperson/partyauthorizedto
receivetheexcessfunds.
3.ThatthereareNOliens,mortgages,deedstosecuredebt,federaltaxes,statetaxesof
anykind,pledgesorotherclaimsofanytype,kindorvarietyagainstsaidproperty.
4.Thatclaimanthasnottransferred,conveyedorencumberedanyofitsrightsorinterest
inthepropertydescribedherein.
SignatureofAffiant
PrintednameofAffiant
Relationshiptotitleholder/ownerofproperty
Sworntoandsubscribedbeforemethisdayof
;.
NotaryPublic
Mycommissionerexpires
ItisthepolicyofTheCamdenCountyTaxCommissioner’sofficethatallthird
partyrequestsforexcessfundswillrequireaninterpleadertobefiledwiththe
SuperiorCourtbytheTaxCommissioner.Excessfundswillbedepositedinthe
court’sregistryfordistributionbyordersofthecourt.