50-182 (08-05/2) [31.08 (4-82)]
TAX CERTIFICATE
Collecting office name Present mailing address (number and street) City, town or post office, state, ZIP code Owner's name Present mailing address (number and street) City, town or post office, state, ZIP code Phone (area code and number) Phone (area code and number) Property account number Collecting tax for: (taxing units in which property is located)
Step 1: Owner's name and address
Step 2: Describe the property
Property description
Step 3: Delinquent taxes
This is to certify that, after a careful check of the tax records of this office, the following delinquent taxes, penalties, interest and any known cost and expenses incurred due to a delinquent tax suit are due on the described property for the following taxing unit(s):
Year Delinquent Taxing Unit Delinquent Taxes, Penalties, Interest and Delinquent Tax Suit Cost and Expenses
1. 2. 3. 4. 5. TOTAL
$ $ $ $ $ $
If applicable, (1) the above-described property has / is receiving special appraisal based on its use, and additional rollback taxes may become due based on the provisions of the special appraisal (Comptroller Rule 9.3040) or (2) property omitted from the appraisal roll as described under Tax Code Section 25.21 is not included in this certificate [Tax Code Section 31.08(b)].
Step 4: Authorized signature
Authorized officer of collecting office
Date of tax certificate