Request for Rates Refund Form

Home Residents Rates & Valuations Request for Rates Refund Form

Request for Rates Refund Form

I want to

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Request for Rates Refund Form
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Request for Rates Refund Form

Applicant Details

Applicant name(Required)
Applicant postal address

Receipt and Payment Details

Property Address(Required)
DD slash MM slash YYYY
Please enter a number greater than or equal to 0.
Max. file size: 100 MB.
Further information may be required to verify some payments

Bank Account Details

Payee Authorisation Details

I, (print name)
Signatory name
for the overpaid rates and/or change on my account as provided on this form. Please make the payment into my nominated bank account, the details of which have been provided above.
Clear Signature

Collection Notice: The personal information requested on this form is being collected by Council for the purpose of processing this request. The personal information will be used by Council for that primary purpose or directly related purposes. The information may also be used to update Council’s customer databases to assist Council in discharging its functions or providing services. The personal information collected will not otherwise be disclosed unless permitted or required by law. If the information is not collected we are unable to process your application and provide the service sought by you. Requests for access to and/or amendment of personal information should be made to Council’s Privacy Officer.

The personal information will be held securely and used solely by the Council for these purposes and/or directly related purposes. The Council may disclose this information to other organisations if required or permitted by legislation.

You may apply to the Council for access to and/or amendment of the information. Requests for access and/or correction should be made to the Council’s Privacy Officer.

A full copy of our Privacy Policy may be obtained from the Information Privacy Policy page or from our Customer Service Centre.