Please Read the Application Carefully

• Make sure all information is completed. Failure to complete the form will delay a decision or may cause the claim to be denied.
• If you check the box that requires evidence for a timely payment, copies of your check book ledger or bank statement may be used.
• If you check the box indicating death, serious illness, or hospital confinement, you may use a doctor's statement as evidence.
• However, the problem must occur within 60 days prior to the due date and the taxes must be paid within 60 days proceeding the due date.
• You will be notified by the County Auditor when remission is granted or denied. The Auditor will apply the credit to your next tax payment or issue a refund.
• Please include a daytime telephone number with your name and address. This will allow for faster processing if the Treasurer or Auditor has any questions.
• If you have any questions concerning the remission form, please call the Treasurer's office at (937) 225-4010 ext. 112 for information.

 Remission Form

After downloading the form, print and mail or deliver to:

Carolyn Rice, Montgomery County Treasurer
451 West Third Street
Dayton, Ohio 45422-0475