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2. I hereby authorize Dara Wren, Logan County Treasurer, to initiate the automatic payment of my real estate taxes by debiting my bank account as indicated below. The tax will be deducted from my account on the Wednesday before the closing date.
   
   The Treasurer will continue to deduct your payment from your account unless we are notified otherwise. You need not request withdrawal each year. Should the Treasurer be denied funds, every attempt will be made to contact taxpayer before the due date. If the Treasurer can not contact taxpayer, penalties and interest will be assessed to any unpaid tax. Provide your bank account information by enclosing a voided check.
4. First Name
5. Last Name
7. How often would you like your taxes withdrawn?
   -- Select One --Semi-annual deduction in February and JulyAnnual deduction in FebruaryMonthly
8. Date
   Date
10. Address1
11. Address2
13. City
14. State
15. Zip
17. Real Estate Tax Address (if different from mailing address)
19. Parcel Number(s)
21. Telephone Number (day)
22. Telephone Number (evening)
24. Return completed from to:
    Dara Wren
    Logan County Treasurer
    
    100 S. Madriver St.
    Bellefontaine, OH 43311
    
    937-599-7223
    
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