I received the monies listed below as disputed funds in a fiduciary capacity;
The disputed monies relate to real property in this county;
The disputed monies are not a residential security deposit;
I notified the persons who are claiming ownership in the money of my intent to deposit the monies with the Clerk
of Court and of their right to initiate a special proceeding to recover the disputed monies, and
I sent the notice to the persons claiming the disputed monies at least 90 days prior to filing this "Certificate of Notice
and Deposit of Disputed Monies" by hand-delivering mailing by first class mail to the addresses listed
below, which are the last addresses known to me.
Deputy CSC Assistant CSC Clerk Of Superior Court
STATE OF NORTH CAROLINA
File No.
County Where Notarized
AOC-SP-260, Rev. 3/12
© 2012 Administrative Office of the Courts
Notary
SEAL
Date
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Name And Address Of Person 1
Name And Address Of Person 3
Name And Address Of Person 5
Name And Address Of Person 7
Name And Address Of Person 2
IN THE MATTER OF:
Name Of Real Estate Broker Or Attorney Depositing Monies
Broker License Number Or NC Attorney Bar No.
CERTIFICATE OF NOTICE AND
DEPOSIT OF DISPUTED MONIES
G.S. 93A-12
I, the undersigned, certify that
Amount Of Disputed Funds
$
Name And Address Of Person 4
Signature Of Person Authorized To Administer Oaths
Date My Commission Expires
Name Of Real Estate Broker/Attorney (Type Or Print)
Signature Of Real Estate Broker/Attorney
Date
Name And Address Of Person 6
Name And Address Of Person 8
In The General Court Of Justice
Superior Court Division
Before The Clerk
County
a real estate broker licensed in North Carolina.
an attorney licensed in North Carolina.
I am:
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