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PARK COUNTY ASSIGNMENT OF TAX LIEN CERTIFICATE OF PURCHASE FOR VALUE RECEIVED, I HEREBY ASSIGN ALL RIGHT, TITLE AND INTEREST IN TAX LIEN SALE CERTIFICATE OF PURCHASE # ACCOUNT # TO: ADDRESS OF: ON 20 . Signature Company, if applicable Title, if applicable This foregoing instrument was acknowledged before me on by: of individual(s)). For: if applicable) As: if applicable) (SEAL) (Notary’s official signature) (Title of Office) (Commission Expiration) Return to: Park County Treasurer PO Box 638 Fairplay CO 80440