REDEMPTION REQUEST

* Indicates a required field.

Submitters FIRST and LAST Name*

Submitters Email*

Block *

Lot *

Qualifier

Property Owner *

Property Location *

Redeeming Party * PLEASE PROVIDE ADDRESS WHERE CERTIFICATES ARE TO BE MAILED


PROOF OF LEGAL INTEREST REQUIRED. HOMEOWNER MAY BE REQUIRED TO SUBMIT A COPY OF DRIVER’S LICENSE. IF YOU WANT TO SUBMIT THIS FORM BY MAIL CLICK HERE TO DOWNLOAD A PRINTABLE PDF.

Person Requesting Redemption *

Company (if not owner.) *


Enter N/A if the owner is requesting.

Phone Number *

Fax Number

Date Payment Will Be Received in Our Office *


PLEASE CHOOSE YOUR PAYMENT DATE CAREFULLY AS THIS IS THE DATE THAT PAYMENT MUST BE RECEIVED IN OUR OFFICE. IF RECEIVED BEFORE OR AFTER THE DATE REQUESTED, FUNDS WILL BE RETURNED.

Message from Submitter (if any)

If you want a copy of this form to be sent to you via email enter your email address here:

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**PLEASE NOTE AFTER TWO REQUESTS ON THE SAME CERTIFICATE, A $50.00 FEE MUST BE COLLECTED FOR EACH ADDITIONAL REQUEST PER CALENDAR YEAR.**