Enrollment Request Form

Taxpayers who are behind on paying their property taxes MAY be eligible for a monthly payment contact.

Before getting on a payment plan, please fill out the form below. A representative from our office will contact you with plan details through email. Any attempt to make online payments before the payment plan is agreed to is not considered part of the payment plan arrangement.

Please agree to the following terms with your initials:

It is my responsibility to make monthly payments based on the contract. If payments are missed, I understand I will be notified that the agreement is void and any penalties and interest will be added back to my delinquent balance.

I understand that by completing this form, I am not enrolling into a delinquent payment plan. I understand that completing this form is a request to be contacted by Treasurer's Office Staff with more information about delinquent payment plans.

I understand that any payment made before a delinquent payment plan is agreed to will not be applied to my payment plan.

*Name:
*Mailing Address:
*City:	State: Zip Code:
*Email:
*Phone Number:
*Parcel Identity Number(s):

Would you like automatic Electronic Fund Transferred when your payment plan is set up? Yes No