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We are collecting your personal information in accordance with the Information Privacy Act 2009 for the purpose of processing this application/request. The information will be only accessed by authorised employees. Your information will not be given to any other person or agency unless you have given us permission, or we are required by law.

Property owner details

Applicant's name*

First Last

Email*

Phone*

Postal address*

Street or post office box Address Line 2 Town/City State Post code Country

Property address*

Street Address Address Line 2 Town

Property number*

From your rate notice.

Lot on plan

E.g. Lot 4 on RP732163

Balance outstanding as at (date)*

Amount

Perodic payment plan

Preferred installment plan

Weekly

Fortnightly

Monthly

Proposed payment based on preferred installment plan*

Date first payment is due*

Declaration

Acknowledgement*

I have read and understood the Tablelands Regional Council's Debt Recovery Policy.

I understand that, in accordance with the Local Government Act 2009 and Council’s budget resolution, all overdue rates will be charged compound interest, calculated daily up to the date of payment.

I understand that should the payment plan not be met (without agreement from TRC) then the payment plan is considered cancelled and full payment of the outstanding amount is due immediately. The unpaid amount and all remaining amounts become an overdue rate as defined by Section 132 of the Local Government Regulation 2012.

I understand that failure to pay may mean TRC shall undertake legal recovery and I accept that the cost of the legal recovery will be charged to me.

I hereby undertake to pay the outstanding balance including any accrued interest by periodic payments so as to clear all outstanding balances by within the half-year period of issue, being 31 December or 30 June within the financial year.

Arrangement To Pay Rates

Property owner details

Perodic payment plan

Declaration