Certificate of Value
Grantor/Assignor: _______________
_________________________________
_________________________________
Grantee/Assignee: ______________
_________________________________
_________________________________
Legal Description:
__________________________________________________________
Date of instrument: _______________
Relationship of grantor/assignor and grantee/assignee:
___________________________________________________________
Total purchase price: $_____ (________________ &___/100 dollars)
Other consideration exchanged for the property: ________________
Terms of payment if other than payment in full at the time of the sale:
__________________________________________________________
______________________________ _________________________________
Assignor/Seller Assignee/Buyer
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