Change or Cancel a TIPP, ACHM or ACH2 Agreement

Use this form to change your bank account or to cancel a monthly or semi-annual payment agreement.

All questions must be answered unless they say (optional).

What do you want to do?

I am telling the Lucas County Treasurer’s Office that

About you

Name

We use this only to reply about this request.

Your mailing address

New bank account

The document must show your bank’s name, your name, the routing number and the account number. PDF, JPG or PNG, up to 10 MB.

What type of bank account is this?

Sign and send

What you send is kept by the Lucas County Treasurer’s Office as a public record under Ohio law. Bank account numbers and identity documents are not released to the public.