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Property Tax Pre-Authorized Payment Plan

Cancellation or Banking Information Change Form

Please note changes and cancellations are required by the 20th day of the month to be effective for the current month’s withdrawal.

Tax Roll #: (optional)

Date:

Address:

Phone Number:

Email:

Current payment plan:

Due Date (end of February, April, June, and August)

Monthly

Identify the change you require

Cancel my pre-authorized payment plan

Change from Due Date withdrawals to Monthly withdrawals

Change from Monthly withdrawals to Due Date withdrawals

Change the bank account that my payments are withdrawn from

Signature 1

Clear

Signature 2

Clear

Name 1

Name 2