Application For Paying Your Real Estate Taxes Quarterly

You do not have to reapply each year. New coupons will be mailed to you by February of the next year showing your new installment amount bases of the previous year’s taxes paid. If you wish to cancel, amend or suspend an installment, you must submit your request in writing no less than 5 days prior to the due date to the Cooper County Collector to allow time for processing.

I (we) ____________________________________________have read the above information and wish to enroll in an installment plan for our real estate tax parcel listed below beginning with the 2009 tax payment. I (we) understand that there will be a total of 4 installments based on the amount that was paid for the previous year’s tax. Three installments will consist of equal installments with the fourth and final being the balance due of the tax due. I (we) understand that all payments are due by December 31^st and that the failure to make a scheduled payment may result in late charges and or the termination of said payment plan.

Upon receipt of this signed agreement, coupons will be sent for you to begin your installment payments. The total paid will be noted on your current year’s tax bill.

Name as show on bill(s) ______________________________________

Mailing address________________________City_________State______Zip_________

Home Phone Number ______________Daytime Number _____________

Email Address _____________________Cell Phone #_______________

Account numbers wishing to set up on this installment plan:

Signature(s)________________________________________________

(all owners must sign)