Third Party Notification Program Online Return Form
* Required Information
Owner Information
 
* Parcel No/AIN:
* Last Name:
* First Name:
  House Number:

Direction:
  Street: City:
  State: Zip Code:
  Daytime Phone:    
  Evening Phone:
  Date of Birth: (ex. 2003)
  Email:

Third Party Information

Please notify this Third Party if my property tax becomes past due. This Third Party is not responsible for paying my bill, he/she will remind me to pay the bill.

* Relationship:
  Agency Name :
* Last Name:
* First Name:
* Address:
* City:    
* State: * Zip Code:
  Daytime Phone:      
  Evening Phone:
  Email:  


DISCLAIMER: By submitting I understand that I am still obligated to pay the tax bill on time. I understand that the Tax Collector is not liable for failure to notify the Third Party. I further understand that the Third Party is not obligated either to take action or to pay any part of my bill.