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SURRY COUNTY DEED AND TAX CERTIFICATION Please furnish the following information:

North Carolina G.S. 105-361. (a)

Duty to Furnish Certificate. On the request of any of the persons prescribed in subdivision (a) (2), below, the tax collector shall furnish a written certificate stating the amount of taxes and special assessments for the current year and for prior years is his hands for collections (together with any penalties, interests, and costs accrued thereon) including the amount due under G.S. 105-277.4 (c) if the property should lose its eligibility for the benefit of classification under G.S. 105-277.2 et seq. that are a lien on a parcel of real property in the taxing unit.

North Carolina G.S. 105-361 (a).2

Duty of Person making Request. With respect to taxes, the collector shall not be required to furnish a certificate unless the person making the request specifies in whose name the real property was listed for taxation for each year for which the information is sought. With respect to assessments, the tax collector shall not be required to furnish a certificate unless the person making the request furnishes such identification of real estate as may be reasonably required by the tax collector.

Buyer(s): ___ Deed Book & Pages: ___

Buyer(s):
Deed Book & Pages:

Parcel ID # ___ (One Parcel per form please.) Original Deed must have Parcel Number included.

Parcel ID #

Name Of Current Owner(s): ___

Name Of Current Owner(s):

Is the Parcel to be conveyed โ˜ in whole or โ˜ in part?

ParcelConveyed
ParcelConveyed

Is there a manufactured home on the property? Make And Model

Is there a manuafactured home on the property?
Make And Model

Property Owners(s) for the past 10 years:

Year Name Parcel Number (Office use only)

_____

Owner1
Year1
Owner2
Year2
Owner3
Year3
Owner4
Year4
Year5
Owner5
Year6
Owner6
Year7
Owner7
Year8
Owner8
Year9
Owner9
Year10
Owner10

Date Signature:

Date

ation must be filled out before the Tax Department can certify th

(Fax 336-401-8132)

(Fax 336-401-8132)

Surry County Deed And Tax Certification (Office use Only)

Property Description: ___

Property Description:
Township:
Parcel ID#:
Personal Valuation: $
Real Valuation: $

Personal Valuation: $

Exemptions: $ ___

Exemptions: $

Value Of Manufactured Home: __Deferred: ___

Value Of Manufactured Home: $
Deferred: $

Statement Of Taxes Due

Year Name

Total Due

2023

Total Due

Owner1
Year1
Owner2

____

Year2
Owner3
Year3
Owner4
Year4

___ ___

Year5
Owner5

_____

Year6
Owner6

____

___ ___

Year7
Owner7

___

Year8
Owner8

___

I am

Year9
Owner9
Year10
Owner10

Other Personal Property Taxes Due: ___

Other Personal Property Taxes Due:

Total Dues As Of ___ $ ___

Total Dues As Of

Additional Cost And/Or Interest Will Be Added: ___

Additional Cost And/Or Interest Will Be Added:

G.S. 105-277.4

Deferred taxes in the amount of $_____ plus interest will become due upon disqualification of Use Value Assessment. I certify that in accordance with G.S. 105-361, the above is a true statement of the tax status for individual(s) listed above, in my hands for collection.

Date Signature:

Date

2023

Please print and fax a copy to (336) 401-8106

Print Form