2. By signing and returning this authorization, I give the Garland County Tax Collector approval to email statements and/or delinquent notices.
4. I would like to receive statements and/or delinquent notices.

   1. Yes
   2. No
6. Name
7. Pin
9. Address
11. City
12. State
13. Zip Code
15. Phone Number
16. Email Address
18. Signature
    By typing your name into this field you authorize Garland County to consider this an electronic signature.
19. Date
    Date
21. I understand I will not receive a paper statement. If my email address changes I'll notify the collector's office.
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field