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PT Form 975 (Revised 08/15) Minnesota Department of Revenue <br />Reconveyance of Forfeited Lands to the State of Minnesota <br />By a Governmental Subdivision <br />Under Minnesota Statutes, Section 282.01, Subdivision ld <br />State Deed Tax Due: $1.65 <br />Date: January28,20 <br />WHEREAS, pursuant to the statute now codified as Minnesota Statutes, Section 282.01, Subdivision la(e), the State of <br />Minnesota, on the 28th day of June , conveyed to <br />City of Ramsey <br />a governmental subdivision of the State of Minnesota (hereinafter "Governmental <br />Subdivision"), by state deed numbered , the real property described below (hereinafter "Property") to be <br />used for an authorized public use, and <br />WHEREAS, the Governmental Subdivision has either failed to put the Property to the public use for which it was conveyed, <br />or has abandoned the public use for which it was conveyed, and now desires to reconvey the Property under Minnesota Statutes, <br />Section 282.01, Subdivision ld to the State of Minnesota, to be held in trust according to Minnesota Statutes, Section 281.25, <br />NOW THEREFORE, the Governmental Subdivision, pursuant to said laws, and pursuant to the duly adopted resolution of <br />its governing body number , dated January 28, 2020 , does hereby convey and quitclaim the <br />property in the County of Anoka , described as follows, together with all appurtenances thereunto belonging: <br />Lot 1, Block 1, Autumn Heights 2nd Addition <br />to the State of Minnesota, to be held in trust as provided by Minnesota Statutes, Section 281.25, upon like conditions and with like <br />effect as if the Property had not been conveyed to the Governmental Subdivision for a public use. <br />Check here if all or part of the described real property is Registered (Torrens) 0 <br />STATE OF MINNESOTA <br />County of Anoka <br />) ss. <br />(Name of Governmental Subdivision) <br />By: <br />By: <br />Signature <br />Title Date <br />Signature <br />Title Date <br />The foregoing instrument was acknowledged before me this day of <br />by John LeTourneau and Kurtis G. Ulrich , respectively the <br />Mayor and the City Administrator of a <br />municipal corporation under the laws of the State of Minnesota, on behalf of the municipal corporation <br />Notary Date <br />