Fountain Hill, PA · Lehigh County
Monthly Payment Proposal
Fountain Hill residents use this application to provide financial information and propose monthly payments toward a delinquent balance.
What this form is
The Monthly Payment Proposal lets an applicant describe their finances and suggest an amount and dates for payments on a delinquent balance. It asks for account and service details, household income, dependents, assets, monthly expenses, and circumstances affecting ability to pay. The applicant verifies the statements and agrees to inform the Borough if their financial circumstances improve.
Who needs it
A person proposing payments on a delinquent balance should complete the application and provide the requested financial and account information.
How to submit it
Complete the application in its entirety and return it to the Borough Office at 941 Long Street, Fountain Hill, PA 18015. The form lists 610-867-0301.
About notarization
This document is signed without a notary; the applicant verifies the statements as true and correct under the stated unsworn-falsification warning, then signs and dates it.
How to submit this form
- 1
Download The Application
Download the Monthly Payment Proposal PDF.
- 2
Complete The Application
Fill in the account and personal information, income, assets, expenses, proposed payment amount, and payment dates.
- 3
Review And Sign
Review your statements, then sign and date the application.
- 4
Return It To The Borough
Return the completed application to the Borough Office at 941 Long Street, Fountain Hill, PA 18015.
Frequently asked questions
- What is the Monthly Payment Proposal for?
- It allows an applicant to propose monthly payments toward a delinquent balance and provide information about finances, expenses, and circumstances affecting ability to pay.
- Who should complete this application?
- A person proposing payments on a delinquent balance can complete the application with account, household, income, asset, and expense information.
- Do I need a notary for the Monthly Payment Proposal?
- No. The document is signed without a notary; the applicant verifies the statements under the stated unsworn-falsification warning and signs and dates the form.
- How do I submit the Monthly Payment Proposal?
- Complete the application in its entirety and return it to the Borough Office at 941 Long Street, Fountain Hill, PA 18015.