"Tax Lien Certificate
[Name of Political Subdivision]
v.
[Name of Tax Debtor]
State of Louisiana
Parish of ______________
City of ________________
To: ___________________
On this __________ day of 20____, I, [Name of tax collector], Tax Collector in and for the [Name of political subdivision], in the name of the [name of political subdivision], and by virtue of the authority in me vested by the constitution and laws of the State of Louisiana and in pursuance of the requirements of those laws, having mailed and published the notice required by law and having strictly complied with each and every requirement of the laws relating to delinquent statutory impositions did sell by public auction the tax lien, evidenced by this tax lien certificate, for the property described below.
To-wit:
Ward __________ Section No. _________ Taxes $ __________________
Assessment No. _____________________ Interest __________________
Penalties __________________
Costs ___________________
Total ___________________
Property description: _________________________________________________
[Name and address of Purchaser] being the winning bidder, and having bid the interest rate of _____ %, and having complied with the terms of the auction, is issued a tax lien certificate for the property, which shall be prima facie evidence of the validity of the lien, and the assignment to [Name of Purchaser]. This tax lien certificate entitles him or his successors or assigns to be paid the termination price. He or his successors or assigns shall also be entitled to amounts paid by the certificate purchaser subsequent to the auction as provided by law.
NOW, THEREFORE, all the formalities of the law having been complied with, I [Name of Tax Collector], Tax Collector for the [Name of Political Subdivision], by virtue of the authority in me vested by the laws of the State of Louisiana do by these presents issue and transfer unto [Name and Address of Purchaser], this tax lien certificate to the above-described property with all the improvements thereon. Any person may cause the tax lien certificate to be terminated by paying the termination price.
IN TESTIMONY WHEREOF, I have hereunto signed my name officially at __________, Parish of _____________________, in the presence of the two undersigned competent witnesses, who also signed on this _________ day of ________________, 2____.
Witnesses:
________________________ ___________________________
Printed Name: [Name of Tax Collector]
___________________________
________________________ [Name of Political Subdivision]
Printed Name:
By: _________________________
La. R.S. § 47:2155