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                    "text": "SURRY COUNTY DEED CERTIFICATION\nPlease provide the following information:",
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                    "text": "Per NCGS: 105-303(a)(2);161(a);161.31;161-30(b)",
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                },
                {
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                    "order": 3,
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                    "text": "Buyer(s): ___ Deed Book & Pages: ___",
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                },
                {
                    "id": "p1.4",
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                    "text": "Parcel ID# _____ (One Parcel per form please.) Original Deed must have Parcel Number induced.",
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                    "text": "Name Of Current Owner(s): ___",
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                    "text": "Is the Parcel to be conveyed D in whole or D in part?",
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                {
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                    "type": "text",
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                    "text": "Is there a manufactured home on the property? ___ Make And Model ___",
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                    "text": "Property Owners(s) for the past 10 years:",
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                },
                {
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                    "text": "Year Name\nFarcer Number (Once use only)",
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                },
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                    "text": "Date ___ Signature ___\n***All the above information must be filled out before the Tax Department can certify deed***\n(Fax 336-401-8132)\nStatement of Taxes Due (Office use Only)",
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                    "text": "Property Description:",
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                    "text": "Parcel ID#: ___ Township: ___",
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                    "text": "Personal Valuation: $",
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                },
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                    "text": "Real Valuation: $ ___",
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                },
                {
                    "id": "p1.15",
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                    "text": "Exemptions: $ ___",
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                },
                {
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                    "text": "Value Of Manufactured Home:[p1.16.1] _____",
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                            "text": "_____ Deferred:",
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                    "text": "Year Name Total Due",
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                },
                {
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                    "text": "___",
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                    "text": "Other Personal Property Taxes Due:",
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                },
                {
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                    "text": "Total Dues As Of ___ $ ___",
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                },
                {
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                    "text": "Additional Cost And/Or Interest Will Be Added: ___",
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                },
                {
                    "id": "p1.22",
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                    "text": "G.S. 105-277.4",
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                },
                {
                    "id": "p1.23",
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                    "text": "Deferred taxes in the amount of $. ___ plus interest will become due upon disqualification of Use Value Assessment.",
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                },
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                    "text": "Date ___",
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                    "text": "Signature",
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