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Payment Arrangement Request – Rates
Online Rates Payment Arrangement form
Applicant (full name)
Email
(Required)
Enter Email
Confirm Email
Mobile
Name of Property Owners (list all)
Property Address
(Required)
Postal Address same as above
Yes
No
Postal Address (if different from the Property Address)
Assessment Number
(Required)
Property Number PID
(Required)
Preferred Contact Method
Email
Phone
Payment frequency
(Required)
Weekly
Fortnightly
Monthly
Other
Amount proposed for each payment
(Required)
Payment commencement date
(Required)
DD slash MM slash YYYY
Additional comments, including payment method
Please provide any additional information, and include your preferred payment method (eg Credit card, BPay, Direct Debit etc)
Please note that interest continues to accrue daily on overdue accounts.
Declaration
(Required)
In making this rates payment arrangement request
I will commit to the payment arrangement requested for the outstanding Rates and Charges balance plus interest
I understand that if the payment arrangement is not adhered to, Council may commence proceedings to recover the amount outstanding.
I acknowledge that should this occur, I will be liable for any collection costs, commission and legal costs incurred in the management or recovery of an overdue account
Select All
Name of signatory
I agree that by typing my name above I have signed this application.
For information about how Council collects, uses, and protects your personal information, please see our
Privacy Statement
.
