Austell, GA: Foreclosed or Vacant Property Form

County:*
Tax Parcel #:*
This property is currently vacant*

YESNO
IF THIS FORM IS SUBMITTED TO UPDATE A PRIOR REGISTRATION, THE COUNTY AND TAX ID# MUST BE ENTERED ABOVE, AND THE NEW INFORMATION INPUT BELOW AND PLEASE CHECK YES.

YES
IF THIS PROPERTY HAS NOW BEEN RE-CONVEYED, Enter DATE: *

MonthDayYear
Date
Property Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Conveyance Document
Deed Book
Page
Agent Information
Agent Bus. Name:
No Bus. Name
Name

First NameMiddle NameLast NameSuffix
Phone 1
Format: (000) 000-0000.
Phone 2
Format: (000) 000-0000.
Fax
Format: (000) 000-0000.
Email
example@example.com
Mail Address (No PO Box)

Street Address

Unit #

CityUnit #

Postal / Zip Code
Street Address (No PO Box)

Street Address

Unit #

CityUnit #

Postal / Zip Code
Property Owner Information (Owner, Lender, Mortgagee, or Creditor)
Bus. Name
Title
No Bus. Name
Name

First NameMiddle NameLast NameSuffix
Phone 1
Format: (000) 000-0000.
Phone 2
Format: (000) 000-0000.
Fax
Format: (000) 000-0000.
Email
example@example.com
Owner Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner Street Address (no PO Box)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Acknowledgements

Registrant acknowledges that any change to the above information regarding the property agent, or owner must be submitted within 30 days of the change. Registrant has obtained and read the local government's instructions pertinent to this form.
Date this form submitted*

MonthDayYear
Date
Signature (name entered here on electronic form acts as a digital signature)*
Phone Number*
Format: (000) 000-0000.
Please verify that you are human*
Should be Empty:

Property Information

Agent Information

Property Owner Information (Owner, Lender, Mortgagee, or Creditor)

Acknowledgements