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Delinquent Payment Plan Request Form – Fairfield County Treasurer

Fairfield County Ohio — Office of Treasurer. James N. Bahnsen, Treasurer.

Delinquent Payment Plan Request Form

If you would like to apply for a delinquent payment plan, please fill out this form and return it to our office.

Email: fctreasurer@fairfieldcountyohio.gov

Mailing address: Attn: Delinquent Dept., Fairfield County Treasurer's Office, 210 E Main St. Room 105, Lancaster, OH 43130

How would you like to be contacted regarding your payment plan request:

*Please note to start a payment plan there is an initial deposit payment of 25% of the total tax to get started. All applications are subject to review and approval by the Treasurer's Office. Approval of the payment plan is not guaranteed.

Serve · Connect · Protect. 210 East Main Street · Room 105 · Lancaster, Ohio 43130-3876. Phone: (740) 652-7140. Fax: (740) 687-7147. Website: www.fairfieldcountyohio.gov

Fairfield County Treasurer – Delinquent Payment Plan Request Form (form content follows)

fctreasurer@fairfieldcountyohio.gov

Name of Requestor (required) Parcel Number Property Address Mailing Address (if different from property address) Email address for contact Phone number for contact Comments