Extended Payment Arrangement Form

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The City of Olathe is accepting extended payment applications for residents and businesses experiencing financial hardship directly resulting from the COVID-19 pandemic. Minimum payments must be at least $25 in addition to the regular monthly billed amount. Arrangements may be extended up to 12 months depending on the amount of the account balance. See the chart for additional information.

Please complete the form below and submit for review.

Total Balance Maximum Number of payments
$100 to $149 4 monthly payments
$150 to $299 6 monthly payments
$300 or more 12 monthly payments
Please correct the field(s) marked in red below:

1
Date
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2
Account Information
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Account Information
3
Preferred Payment Plan
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4
You will receive notice once the submission has been reviewed for qualifications. Contact at 913-971-9311 with any questions.
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  • If approved:
  • I agree to pay both the installment payment amount and all current monthly charges on or before the due date.
  • I fully understand that if I do not comply with the terms of this agreement, my utility account will be considered in default, my water service may be turned off without any further notification, and my account may be subject to additional charges.
  • The City of Olathe will provide me with a completed copy of the payment plan agreement shown above, and I authorize the City of Olathe to show my acceptance of the payment agreement.
  • I understand that I will have five business days to contact the City of Olathe at 913-971-9311 to reject the approved payment plan, and my failure to contact the City of Olathe will mean that the payment plan agreement is in effect.
  • I have carefully read these provisions and fully understand them.
5
Please type your full name as an electronic signature to indicate you have carefully read these provisions and fully understand them.
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  1. To receive a copy of your submission, please fill out your email address below and submit.