Red Oak, TX · Ellis County
Request for Payment Extension
Residents requesting more time to pay submit this form with their account details, requested payment date, reason, and signature.
What this form is
This form lets an account holder request an extension to make a payment and state when payment can be made. It asks for contact and account information, the requested extension date, whether an extension was allowed in the past 12 months, and the reason for the request. The form says to attach transaction history to each request and warns that failing to maintain the arrangement may result in a delinquent fee and water service disconnection.
Who needs it
An account holder seeking more time to pay should complete this form and attach transaction history to the request.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed and dated without a notary; attach the transaction history required with each request.
How to submit this form
- 1
Download The Form
Download the Request for Payment Extension form.
- 2
Complete The Request
Enter your contact and account details, requested payment date, extension history, and reason.
- 3
Attach Transaction History
Attach transaction history to the request, as instructed on the form.
- 4
Sign And Date
Sign and date the completed request.
- 5
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Request for Payment Extension?
- No. The form calls for the account holder's signature and date, not notarization. Attach transaction history to each request.
- How do I submit a payment extension request?
- Submit it to the city department named on the form; check the city website for current contact details. Attach transaction history to each request.
- What information does the form ask for?
- It asks for your name, address, account number, phone number, requested extension length or payment date, prior extension history, and reason for the request.
- What happens if I do not maintain the payment arrangement?
- The form warns that a $40 delinquent fee may be assessed, water service may be disconnected without notice, and you may no longer be eligible for payment arrangements or extensions.
Need something notarized?
This Request for Payment Extension doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.