village of plymouth

25 Sandusky St., Plymouth, OH 44865

phone: 419-687-2020 fax: 419-419-5383

Website: Email:

This agreement made and entered into this ______, by and between

(Date)

______, hereinafter referred to

(Name)

as the “client” and the Village of Plymouth Income Tax Department, hereinafter referred to as the “Village”, said agreement made by and through the Fiscal Officer of said Village.

WITNESSETH: This agreement is entered into by the Village in an attempt to enable the client to pay off his/her income tax account over a period of time in order to avoid legal action.

NOW THEREFORE,it is agreed by and between the parties hereto as follows:

1. Client agrees to pay the Plymouth Income Tax Department a payment of at least $______

I authorize the Village of Plymouth Income Tax Department to make withdraws from my credit/debit

Cardon a WEEKLY______BIWEEKLY______MONTHLY______basis in the

Amount of $______beginning on ______.

Name on Credit/Debit Card: ______Phone #______

Card Number: ______

Expiration Date: ______Billing Zip Code: ______

Security Code (3 digit on back of card): ______

2. Client acknowledges and consents that by signing this agreement it extends the statute of limitations as per Ohio Revised Code 718.12(A), statute for civil recovery actions).

3. Client acknowledges that he/she understand that if a scheduled payment is not received per your agreement, legal action will commence.

4. Client acknowledges that he/she understands that penalty and interest will accrue at a rate of 1% each per month on the outstanding tax balance.

5. Client agrees that the Village may increase the amount of the scheduled payment, if it is determined that the payments will not pay off the account balance in a timely manner.

6. Village agrees to notify the client at least two weeks prior to any increase in the amount of the scheduled payment.

7. Client agrees to notify the Village of Plymouth Income Tax Department when any information changes, including mailing address and telephone number.

IN WITNESS WHEREOF, the parties have hereunto set their hands on the date first mentioned.

______

Client City File #

______

Fiscal Officer Witness