OFFICE OF THE

TAX COMMISSIONER DeAnn Cruse

Tax Commissioner

OFFICIAL CLAIM FOR TAX SALE EXCESS FUNDS

Complete all fields entirely. Do not alter this form in any way. Incomplete, non-notarized,
and/or altered forms will not be accepted.

You must attach all required supporting documentation, including a copy of your valid
driver's license or other valid U.S. Government issued identification or foreign passport.
Claims that are not accompanied by this documentation will not be accepted.

You are not required to pay, or to be represented by, a third party in order to make a
claim. The Tax Commissioner’s Office can help you with this claim. Claims from third
parties, other than an attorney who has been retained by an entitled party for the purpose
of handling this claim, are not accepted. Attorneys need to provide their Georgia bar
number as verification along with a power of attorney.

STATE OF GEORGIA
COUNTY OF MERIWETHER

Affidavit of _____________________________ _____________________________

Name of Claimant Phone Number

______________________________________________________________
Legal Name of Entity with Lien Holder Interest, if applicable.

______________________________________________________________
Street Address (Required)

___________________________ ___________ _____________

City State Zip Code

_____________________________________ __________________
Parcel Identification Number/Map Code Tax Sale Date

______________________________________________________________
Property Address

_$_________________________
Amount of Claim

______________________________________________________________
Reason you are entitled to receive excess funds (attach supporting documentation)

126 N. Court Square (P.O. Box 729), Greenville, GA 30222 | Phone (706) 672-4219 Fax (706) 672-6147
DeAnn Cruse, Tax Commissioner – [email protected]
www.meriwethertax.com
OFFICE OF THE
TAX COMMISSIONER DeAnn Cruse
Tax Commissioner

The above claimant acknowledges the following under oath by signing below:

1. I am the recorded title holder and owner of the property, or a recorded owner of a security
interest in the property, or a party with an equity interest in the property that was on record
at the time of the tax sale. O.C.G.A § 48-4-5
2. I have attached to this claim form a copy of my valid U.S. Government identification or
foreign passport.
3. I affirm that there are no outstanding liens, mortgages, and deeds to secure debt,
encumbrances, or other claims or entitlements of any kind whatsoever against the property,
senior to or of greater legal priority than my right to receive excess funds.
4. In exchange for the release of excess funds generated by this tax sale, the undersigned
does hereby agree to hold harmless the Meriwether County Tax Commissioner, the
Meriwether County Board of Commissioners, the Meriwether County Sheriff and all Sheriff’s
employees, including Ex-Officio Sheriffs, all Meriwether County Officers, Officials and
employees, their agents, representatives, successors, and assigns, from any and all claims,
demands, obligations, actions, causes of actions, rights, damages, costs, attorney’s fees,
expenses and compensation of any nature whatsoever, which may arise from the
distribution of the referenced excess funds
5. There are no lawsuits, garnishments, bankruptcies or other judicial or quasi-judicial
proceedings pending against me that might affect my claim for excess funds.
6. The Meriwether County Tax Commissioner has the right to set off and may first apply any
excess funds against any and all outstanding obligations of the claimant which are past due,
or due and payable to the Meriwether County Tax Commissioner.
7. I agree to remit to the Meriwether County Tax Commissioner the total amount of excess
funds disbursed to me in the event entitlement to the excess funds is successfully
challenged.
8. I further agree that if the potential for competing claims exists for the excess funds, the Tax
Commissioner has the right to interplead the excess funds into Meriwether County Superior
Court for a determination as to who is entitled to receive them pursuant to O.C.G.A. § 48-4-
5.
9. This affidavit is a sworn statement and false swearing is punishable as a felony under the
laws of the State of Georgia, O.C.G.A. § 48-5-444

This ______ day of _______________, _______ Sworn to and subscribed before me this

_______________________________________ ____ day of ______________, _______

Claimant’s Printed Name

_______________________________________ ________________________________
Claimant's Signature Notary Public
(Notary Seal)

126 N. Court Square (P.O. Box 729), Greenville, GA 30222 | Phone (706) 672-4219 Fax (706) 672-6147
DeAnn Cruse, Tax Commissioner – [email protected]
www.meriwethertax.com
OFFICE OF THE
TAX COMMISSIONER DeAnn Cruse
Tax Commissioner

OPTIONS FOR SUBMITTING THIS FORM

1. Place in the black drop box located directly in front of the Tax Commissioner’s office located
at 126 N. Court Sq., Greenville, GA 30222

2. Drop off in the office.

3. Mail to: Meriwether County Tax Commissioner

Excess Funds
P.O. Box 729
Greenville, GA 30222

4. If sent by FedEx or UPS:

Meriwether County Tax Commissioner

Tax Commissioner – Excess Funds
126 N. Court Sq.
Greenville, GA 30222

126 N. Court Square (P.O. Box 729), Greenville, GA 30222 | Phone (706) 672-4219 Fax (706) 672-6147
DeAnn Cruse, Tax Commissioner – [email protected]
www.meriwethertax.com