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GRANTEE FORM <br /> <br /> <br />C.S.: 2713 (12=10) 903 <br />County of Hennepin <br />Parcel: 16 <br /> <br />Sale Number 139477 <br /> <br /> <br />I request that ____________________________ Joint Tenants or Tenants in Common (circle <br />one), be named as Grantee(s) on the Quit Claim Deed for the State of Minnesota, Department of <br />Transportation. <br /> <br /> <br /> <br />______________________________ <br />Signature <br /> <br />Please name the County in which the Grantee resides: _________________ <br /> <br />If more than one (1) Grantee is to be named in the Quit Claim Deed, please indicate if the <br />Grantees are taking title as husband and wife. <br /> <br /> <br />Please return this form to: <br /> <br />Jennifer Bailey Matti, L.S. <br />Minnesota Department of Transportation <br />Office of Land Management – MS 632 <br />Shared Services Center – Property Conveyance Unit <br />395 John Ireland Blvd. <br />St Paul, MN 55155-1800 <br /> <br /> <br /> <br /> <br />