MadisonCounty, Iowa

REGISTRATION OF TAX SALE BIDDER OR ASSIGNEE

June 19, 2017 Annual Tax Sale

and Subsequent Adjournments or Assignments Thereof

Notice: All bidder registrations and authorizations to represent bidders must be filled out, signed, and returned to the Treasurer’s Office by 4:00 P.M. on Tuesday, June 13, 2017. There will be NO registrations after that, including on the day of sale. This office reserves the right to accept or deny last minute authorization changes.

The undersigned does hereby register as a bidder at the annual tax sale and subsequent adjournments or assignments thereof, and does hereby acknowledge receipt of a copy of the Madison County “NOTICE TO TAX SALE PURCHASERS OF THE TERMS AND CONDITIONS GOVERNING THE TAX SALE”, and does further hereby acknowledge and agree that by placing a bid or obtaining a certificate of purchase at the Madison County annual tax sale or subsequent adjournments, or by obtaining a tax sale assignment from Madison County, that the undersigned will comply with and be bound by aforementioned terms and conditions. Also be advised that any information written on this form is essentially public information (except social security numbers and FEINs), and may be provided to requestors in the future.

Said “NOTICE TO TAX SALE PURCHASERS OF THE TERMS AND CONDITIONS GOVERNING THE TAX SALE”, is based, in part, on the current Code of Iowa and amendatory acts thereof.

By signing below, I certify that the bidder, if not an individual, has a federal tax identification number and either a designation of agent for service of process on file with the Iowa Secretary of State or a verified statement of trade name on file with the Madison County Recorder. I will submit the necessary forms to the county treasurer upon my “first time” tax sale registration; I am self-certifying subsequent years with this form unless my situation changes and I need to submit new forms.

This is notification to the undersigned that the CountyTreasurer is not an attorney and will not act as agent except to provide information as required. It is the responsibilityof the undersigned to do necessary research before deciding to bid, to pay subsequent taxes if desired, and to proceed to tax sale notifications in order to safeguard the investment.

Please print or type the following information

Bidder/Company Name ______

I.D. # ______County of Residence ______

(SS# or Federal ID#)

Address ______

City ______State_____ Zip______

Telephone Number (___) ______Email address ______

Have you ever purchased a tax sale certificate in MadisonCounty? ( ) Yes ( ) No

Tax Sale Certificates to be: ( ) Mailed ( ) Picked up at Treasurer Office

Signature ______Date______

NOTE: All tax sale certificates of purchase and tax sale deeds, whether through tax sale or by assignment, will be issued in the bidder’s name as shown above. Please enclose $25 per bidder as registration fee.

Jana S. Corkrean, Madison County Treasurer

TO:

Jana S. Corkrean

Madison County Treasurer

P.O. Box 152

Winterset, IA 50273

AUTHORIZATION TO REPRESENT BIDDER

I/We, (Please print or type) ______

(Bidder’s Name, as it appears on the Registration Form)

authorize (Please print or type) ______

(Representative Name)

to act as my/our agent/personal representative at the June 19, 2017 Madison County, Iowa,

tax sale and any adjourned sales, thereof.

______

(Printed Name of Bidder)

______

(Signature of Bidder)

______

(Address)

______

(City, State, Zip Code)

Date ______

Subscribed and sworn to me this ______day of ______, 2017

______

(Signature of Notary)

This form will not be notarized by an employee of the Madison County Treasurer’s office. Form is not considered complete until all information is filled in, signed by same person who signed the Bidder Registration form and W-9 form, dated, and notarized. There is currently no fee to authorize a representative. Later Substitutes should bring a new authorization form and appropriate ID and not wait until the last minute to register.