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PLC:

a003dw

Agency:

upper dublin township tax collector

For:

tax certification orders & payments

Phone:

215-646-4794

Address:

370 commerce drive
fort washington, pennsylvania 19034

*Required Field

Payment Information

GENERAL INFORMATION: Tax Certification Fee: $40.00* *If paid by credit card there is a $1.00 non-refundable fee added to pay a third party vendor *If paid by e-check there is a $0.50 non-refundable fee added to pay a third party vendor.

*Requestor's Name:

Company Name:

*Requestor's Telephone Number:

(### - ### - ####)

Tax Certifications will either be faxed or emailed to the requestor.

Requestor's Fax:

(### - ### - ####)

Tax Certifications will either be faxed or emailed to the requestor

Requestor's Email Address:

*Parcel #:

*Property Owner Name:

*Property Address::

*City:

*State:

*Zip:

*Sale/Refinance/Other:

If Sale, settlement date:

(Month / Day / Year)

Tax Certification Fee: $40.00* *If paid by credit card there is a $1.00 non-refundable fee added to pay a third party vendor *If paid by e-check there is a $0.50 non-refundable fee added to pay a third party vendor.

Payment Amount

*Payment Type:

Tax Certification Fee :

Subtotal:

$0.00

Total:

$0.00

Billing Information

*First Name:

Middle Initial:

*Last Name:

*Billing Address:

*City:

*State/Province:

*Zip:

*Country:

*Phone Number:

*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

*Card Security Number:

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