How do I submit the payment plan request?

Fill in only the top section and return it to Wilson Creek Town Hall for consideration. The form lists the Town Hall address as 254 Railroad Street, Wilson Creek.

What happens after I return the form?

The clerk or treasurer calculates the monthly payment amount and returns the agreement for your signature. A copy is then provided by email.

What information does the form ask for?

It asks for the account holder’s name, phone number, mailing address, account number, and email address. The clerk or treasurer completes the payment amount and office-use fields.

Wilson Creek, WA · Grant County

No notary required

Current Year Payment Plan Affidavit

Wilson Creek account holders use this form to request a six-month payment plan for a current past-due balance.

What this form is

This form lets an account holder request a six-month plan to pay a current past-due balance. Fill in only the top section and return it to Town Hall for consideration; the clerk or treasurer calculates the monthly payment amount and returns the agreement for signature. The request is not approved until the clerk or treasurer signs it.

Who needs it

An account holder with a current past-due balance who wants to request a six-month payment plan from the Town of Wilson Creek.

How to submit it

Fill in only the top section and return the form to Wilson Creek Town Hall for consideration. The form lists Town Hall at 254 Railroad Street, PO Box 162, Wilson Creek, WA 98860.

About notarization

This document is signed without a notary; the signer signs and dates it and certifies under penalty of perjury that the information is true and correct.

How to submit this form

1
Download The Form
Download the Current Year Payment Plan Affidavit PDF.
2
Complete The Top Section
Fill in only the top section with your contact details, account number, and email address.
3
Return It To Town Hall
Return the form to Wilson Creek Town Hall for consideration; the clerk or treasurer calculates the monthly payment amount.
4
Sign The Agreement
Sign and date the agreement when it is returned to you. The request is not approved until the clerk or treasurer signs it.

Frequently asked questions

Do I need a notary for the Current Year Payment Plan Affidavit?: No. The signer signs and dates the form and certifies under penalty of perjury that the information is true and correct; no notary is indicated.
How do I submit the payment plan request?: Fill in only the top section and return it to Wilson Creek Town Hall for consideration. The form lists the Town Hall address as 254 Railroad Street, Wilson Creek.
What happens after I return the form?: The clerk or treasurer calculates the monthly payment amount and returns the agreement for your signature. A copy is then provided by email.
What information does the form ask for?: It asks for the account holder’s name, phone number, mailing address, account number, and email address. The clerk or treasurer completes the payment amount and office-use fields.

Need something notarized?

This Current Year Payment Plan Affidavit doesn’t need a notary — but if you have another Wilson Creek form that does, a commissioned online notary can help.