GA - Surplus Funds

Authorization Form

Assistance to Receive Surplus Funds
Owner Name (as shown on Deed)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Auction Address

Street Address

Street Address Line 2

CityState

Zip Code
Auction Address - County
To verify you are the owner, the court requires a copy of the front & back of your driver's license. Are you ready to upload now?
The court requires Front and Back of Driver's License. You can take new pictures or upload from photo library.

Cancelof
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
I have read and agree to the below Authorization form.
- Welcome to Gap Recovery.
  
  We've helped hundreds of individuals, families, and businesses locate and recover money that the government owes them. Our GA office and legal team of experts will work tirelessly to ensure that you receive the compensation you deserve.
  
  We never charge up front. There are no hidden fees. Every case is unique and has its own unique challenges, but we are here by your side for the entire process.
  
  We only charge a fee if we are successful. Our fee comes out of the new money we are able to recover. If we are unseccessful for some reason, you do not owe us anything.
  
  By signing the form, you authorize your County to release, furnish, and provide any information relating to the reference loan to Gap Recovery, LLC.
  
  This authorization is valid for a period of sixty days from the signed date. This authorization may be revoked, in writing, by the Borrower(s) at any time.
  
  Transfer and Assignment of Excess Tax Sale Proceeds
  
  For and in the consideration of the sum of the mutual promises contained herein, and other good and valuable consideration, all of which is acknowledged to be received as full and adequate consideration by you, the "Assignor" herein. The Assignor hereby transfers and assigns to Gap Recovery, LLC ("Assignee"), without warranty or representation and without recourse, all of the respective rights, title, and interests in and to those certain excess produced from the County tax sale held on by the County Sheriff or Tax Commissioner with respect to the address mentioned herein.
  
  Assignor expressly grants the Assignee its respective claims in any future or present litigation, and hereby includes in this assignment Assignor's rights, if any, to participate in such litigation. Assignor further agrees to cooperate with Assignee in such litigation. Assignor warrants and represents that it has authority to enter into this Assignment, and that, prior to the execution of this Assignment, it has not sold, assigned, granted, conveyed or transferred its claim to the excess funds referenced above to any other person or entity any of the rights, obligations, claims, demands, actions or causes of action described herein.
  
  Once the funds are received by Gap Recovery, LLC, the Assignor will receive 65% of the net excess funds collected after deducting the costs advanced by Assignee in connection with obtaining the excess funds.
- Should be Empty:

Authorization Form