Direct Payment Authorization Request Form

The Direct Payment program allows you to make payments on your Wise County taxes automatically each month. When you enroll in the Direct Payment program, we will deduct the amount you choose to be applied to your local taxes monthly. The deduction will be on or about the 5th day of each month. To sign up for the Direct Payment plan, you will need to complete and sign an electronic authorization form located below, or contact the Wise County Treasurer's Office to obtain an authorization form. Please contact the Wise County Treasurer's Office with questions or for more information.

Direct Payment Authorization Request Form

  1. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  3. This field is not part of the form submission.