"*" indicates required fields Collection Notice The information we are collecting is necessary to deal with or respond to your enquiry or service request. Your personal information has been collected in accordance with the Information Privacy Act 2009 (QLD) and will not be disclosed outside of Australia. We may not be able to deal with or respond to your request if you choose not to provide your name and contact details. Our Queensland Privacy Policy (QPP) Privacy Policy explains how you may request access to and/or correct your personal information. Our policy also explains how you can complain to us if you consider we have breached our obligations to manage your personal information in accordance with the QPP, and how we deal with privacy complaints.Acknowledgement* I have read and accept the collection notice above. Applicant DetailsName* First Last Email* Phone*Property address Street Address Address Line 2 Town Post code Is your postal address the same as the property address? Yes No Postal address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Refund type* Rates Standpipe bond Planning/development application Cemetery/Burial Hall hire Other Development application number*Lot and plan number*Lot 4 on RP732163Property number*From your rate notice.Reason for refund*Amount to be refunded*Upload proof of payment*Max. file size: 150 MB. Bank account details for electronic funds transferName of bank*Account name*BSB number*Account number*Declaration The details I have provided are true and correct. I understand TRC is under no obligation to verify the accuracy of the bank details provided and will take no responsibility for any delays in payment or errors due to factors outside reasonable pay controls, including but not limited to delays or errors in the banking system or errors in the account details. I agree to return to TRC any payments credited in error, and TRC reserves the right to off-set the amount of any overpayment made in error against any existing or future debt or liability owing to or by TRC. I understand that this refund request will be processed on the next payment run. You must accept the conditions of the collection notice (top of form) and the above statement/s before you can submit this form.
