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Surplus Claim Form

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Surplus Claim Form

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TANEY COUNTY
SURPLUS CLAIM FORM
NOTE: FORM MUST BE SIGNED BY ALL PARTIES AND NOTARIZED
I, __________________________ , shown in the Taney County Collector’s tax records as owner of the property
listed below, hereby claim the surplus amount of $ ____ resulting from the tax certificate sale conducted by the Taney
County Collector on ______ . I affirm that I am/was the legal owner of the below described property at the time the
property was sold at the tax delinquency sale and further affirm I am entitled to the surplus amount. By signing below, I
acknowledge the following:

 Claiming surplus does not waive legal right of property redemption within statutory limits
 The Taney County Treasurer processes surplus claims without charge
 The claim may not be approved as submitted, and additional information might be requested

Property Description:

Property Parcel Number:

Current mailing address:

__________________________________________________________________________________________________
Street

________________________________________________________________________________________________________
City State Zip

Driver’s License/State ID Number_______________________________________________________________
Daytime Telephone Number(s)__________________________________________________________________

________________________________________________________________________________________________________
Signature Date

State of __________________________
County of _________________________

On this _____ day of ________________________ in the year _________, before me, the undersigned notary public,
personally appeared _________________________________________________________, known to me to be the person(s)
whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the named for the
purposes therein contained. In witness whereof, I hereunto set my hand and official seal.

________________________________
Notary Public

Return form to Taney County Treasurer’s Office, 132 David St, MO 65653.
YOU MUST INCLUDE A PHOTO COPY OF DRIVER’S LICENSE(S) OR STATE ID(S).
Once paperwork is received and verified a check will be issued and mailed to address above.

Surplus Claim Form

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