Lassen excess proceeds claim form

Source: https://www.lassencounty.gov/DocumentCenter/View/2492

CLAIM FOR EXCESS PROCEEDS

TO: Taya Short, Lassen County Treasurer-Tax Collector

RE: Claim for Excess Proceeds

I hereby certify that I am a party of interest in the following parcel:

Parcel Number Assesse: Date Sold: Amount of Excess Proceeds: Date Deed to purchaser Recorded:

I claim excess proceeds under Revenue and Taxation Code Section 4675. Enclosed is documentation supporting my claim.

(check the appropriate box)

____ I am claiming these proceeds personally and it is not necessary for me to employ another person to file a claim on my behalf.

____ I have previously given a “power of attorney” to or signed an “agreement” with another person to file a claim on my behalf. I hereby claim such proceeds in my own name and revoke such power of attorney or agreement to claim these funds. I understand I cannot revoke a prior “assignment” of my rights to the proceeds, unless such assignment was issued subsequent to the sale and does not qualify pursuant to Revenue and Taxation Code Section 4675.

I affirm under penalty of perjury that the foregoing is true and correct to the best of my knowledge.

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Signature of Claimant Name of Claimant (please print or type)

Mailing Address: Daytime Phone:
_______________________

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