On-Line Tax Certification Request




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  Today's Date:
Company Name:
Your Name:
Address:
City, State, Zip:
Telephone:
Fax:
E-Mail:

  Parcel #:
Owners Name:
Address:
City, State, Zip:

File/Reference No.  
Check which information you need

  County   Other
  Township  
  School
New Owner's Name & Address
Should this be mailed or faxed?
When is settlement?  

Special Instructions: