PART 1 CONSOLIDATED TAX ACTION STATEMENT OF CHANCERY COURT HAMILTON COUNTY, TENNESSEE PERSON REDEEMING PROPERTY SOLD FILE N0. AT TAX SALE ITEM N0. T.C.A. § 67-5-2704. STATE OF TENNESSEE FOR THE USE AND BENEFIT OF DELINQUENT TAXPAYERS, DEFENDANTS PLAINTIFFS NAME OF REDEEMING PERSON ADDRESS OF REDEEMING PERSON PHONE N0. PROPERTY TO BE REDEEMED DOCKET N0. ITEM N0. MAP N0. TAX SALE DATE I VERIFY I AM ENTITLED TO REDEEM THIS PROPERTY FOR THE FOLLOWING REASON(S): I am the delinquent taxpayer. I am making this redemption for the use and benefit of the delinquent taxpayer. OR (Check each applicable reason): [T.C.A. § 67-5-2701.] I own a legal interest in the property. Describe: ___________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I own an equitable interest in the property. Describe: _______________________________ ______________________________________________________________________________ ______________________________________________________________________________ I have a lien on the property as a creditor of the taxpayer. Describe: ___________________ ______________________________________________________________________________ ______________________________________________________________________________ DATE PRINTED NAME SIGNATURE Page 1 of 1 page. STATEMENT OF PERSON REDEEMING PROPERTY SOLD AT TAX SALE FORM 105, REV. 2007.06.27 American LegalNet, Inc. www.FormsWorkflow.com