Sample Tax-Sale Certificate

TAX SALE CERTIFICATE OF PURCHASE                                                              Form Approved by State Tax Commission

STATE OF MISSOURI                  }                                                                                            No.____0001_________

County of ___Greene_____________}ss.

              I_______Scott Payne________________________, County Collector in and for the County and State aforesaid, do hereby certify that

______John Allen Doe_______________________________________0001 W. Haldis St.    Springfield, MO 65800___________________

                         Name                                                                                   Address

did, on the days hereinafter set forth, between the hours of 10 o'clock A.M. and 4 o'clock P.M. of the respective days, purchase at Public Auction, at the Court

House in _______Springfield__________, the Lands and Town Lots below described, situated in the said County of ______Greene________

 for the taxes, special assessments, interests, penalties and costs due and unpaid thereon for the years A.D. _______________,_____________, ______________,______________, _____2001____,_______2002_____, and paid as purchase money on each tract or lot the total amount of taxes,

special assessments, interests, penalties and costs thereon as stated herein opposite the description of each tract or lot:

       At any time after the expiration of two years from the date of this sale the above-named purchaser, his heirs or assigns, will upon application and

compliance with the provisions of law pertaining thereto, be entitled to a Deed of conveyance for any real estate herein described, which shall not have been

redeemed, provided, that on the failure of the holder of this certificate to take our said deed, as entitled by law, and file the same of record within four years

from the date of such sale, then and in that event the amount due such purchaser shall cease to be a lien on such lands so purchased as herein provided.

          IN WITNESS WHEREOF,  I Hereunto set my name and affix my seal at my office in _________Springfield, MO______________, the

_________25th_________ day of __________August___________, A.D. 2003_.          _________Scott Payne_____________________

                                                                                                                                                     County Collector

          RECEIVED,  this __________26th______________ day of _________August________, A.D. 2003_, of ___John Allen Doe___________

the sum of  ______Ten Thousand Seven_________ Dollars and ____________00/100_________________ cents, the amount of purchase money

on the above tract or lot of land.

                                                                                                         _______________________Scott Payne_____________________

                                                                                         County Collector, __________Greene______________ County, Mo.

          I, _________Scott Payne______________ County Collector, in and for __________Greene_______________ County, Missouri, here-

by guarantee the above to be the true amount due against said land above described as the same appears upon the records.

_____________________________________________________________________________________________________________________________

STATE OF MISSOURI           }

County of ___________________}ss.

          In considerations of the sum of ____________________________________________________________________________ dollars to me paid by

___________________________________________________________ of the County of _________________________________________ and State of

_______________________________, I, the within named _____________________________, do hereby sell, *assign, transfer and set over to the said

______________________________________________________________________________, his heirs, executors, administrators and assigns the within

certificate of purchase and all my right, title and interest in or to the real estate therein described, to have and to hold to the said _______________________

his heirs, executors, administrators and assigns, to his and their sole use, benefit and behoof forever.

          Given under my hand and seal, this _________________________ day of ________________________ A.D., 20___.

                                                                                                                              __________________________________________  (SEAL)

______________________________________________________________________________________________________________________________

ACKNOWLEDGMENT

STATE OF MISSOURI         }

County of __________________}ss.

          On this _________________________ day of ________________________, 20___, before me, a Notary Public within and for the County and State

aforesaid, personally appeared _____________________________________________________________________________________________________

who acknowledged the foregoing instrument to be his free act and deed.

         IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this the ______________________________________________ day of

_______________________________________, 20___.                                               ______________________________________________

                                                                                                                                                           Notary Public

         My Commission expires ________________________ day of ________________________________, 20___.

*Not subject to assignment to a non-resident without appointment of a resident agent, according to the latest Revised Statutes of Missouri.

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