* Denotes that the field is mandatory.
Title
Given Names
Surname/Company Name *
E-Mail Address *
Home Telephone
Mobile Telephone
Work Telephone
Previous Postal Address *
New Postal Address: eg PO Box or the street number and street name *
Town/Suburb *
State *
Post Code *
Is this new postal address for all Council correspondence?
Is the new postal address only for your Rates Account?
Is the new postal address only for your Water Account?
Is the new postal address only for your Debtors Account?
List any applicable Assessment/Account Numbers and/or property addresses you own?
Council's Policy requires that you to supply your current address of where you live.
Address of where you live *
Town/Suburb *
State *
Please attach any related images or documents. Attachments must be no larger than 5MB. Accepted file formats include .doc, .docx, .jpg and .pdf, ie Power of Attorney
Attachment File 1
Attachment File 1 Description
Attachment File 2
Attachment File 2 Description