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INSERT NAME OF TAX COLLECTOR
Tax Collector,INSERT COUNTY NAME
ENDORSEMENT FORM
I, ____________________________________________, the Transferor/Owner of the Certificates(s) listed below, hereby transfer all my rights, title, and interest in and to the following tax certificate(s):
CERTIFICATE NUMBER------ TAX ACCOUNT NUMBER------ PARCEL ID NUMBER
_____________________ ______________________ ________________________
_____________________ ______________________ ________________________
_____________________ ______________________ ________________________
To: ____________________________________________________________________________________
Name of Purchaser
Dated this _______day of ___________________________.
Day Month, Year
_____________________________________________
Signature of Transferor
_____________________________________________
Printed Name of Transferor
____________________________________________
Title
Endorsement must be acknowledged before the Tax Collector or a Notary Public.
ACKNOWLEDGEMENT
State of ______________________________
County of _____________________________
I HEREBY CERTIFY that on this day before me personally appeared _____________________________ to me known to be the person described in the foregoing tax certificate(s), which person acknowledged before me that he executed the foregoing endorsement. WITNESS my hand and official seal this ________________ day of ______________________.
_____________________________________
Tax Collector or
_____________________________________
Notary Public
My Commission Expires: ____________________
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