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# SURRY COUNTY DEED CERTIFICATION Please provide the following information:

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

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