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Forms

Flood Event 2022 Financial Relief Application - Displaced Resident

Required fields are marked with an asterisk (*).
Applicant Details
Please complete with full name of Property Owner/Declarant
Assessment numbers are located in the top right corner of the rates notice
Declaration
Displaced Person Declaration * I declare that I am a Displaced Resident and that the above property is my principal place of residence (proven by the property address being against my name on the House of Assembly Roll), and request the deferral of payment for any of the following outstanding rate instalments, 9 December 2022, 10 March 2023 and 9 June 2023 until the 30 June 2023, after this date I understand that monthly fines and interest will once again commence to be charged for any overdue rates. I also request (if applicable to this property), to apply for the rebate of the Community Wastewater Management Scheme service charge for the approximate period of time that the service is not available, I understand that the rebate credit will be passed on a monthly basis to my property.