Per NCGS: 105-303(a)(2);161(a);161.31;161-30(b)
Buyer(s): ___ Deed Book & Pages: ___
Parcel ID# _____ (One Parcel per form please.) Original Deed must have Parcel Number induced.
Name Of Current Owner(s): ___
Is the Parcel to be conveyed D in whole or D in part?
Is there a manufactured home on the property? ___ Make And Model ___
Property Owners(s) for the past 10 years:
Year Name Farcer Number (Once use only)
Date ___ Signature ___ ***All the above information must be filled out before the Tax Department can certify deed*** (Fax 336-401-8132)
Statement of Taxes Due (Office use Only)
Property Description:
Parcel ID#: ___ Township: ___
Real Valuation: $ ___
Personal Valuation: $
Exemptions: $ ___
Value Of Manufactured Home: ____Deferred: _____
Year Name Total Due
___
Other Personal Property Taxes Due:
Total Dues As Of ___ $ ___
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.
Date ___
Signature