Online Form - eRates Competition

First Name*

Middle Name

Surname*

Postal Address

Street Address:

City:

State:

Post Code:

Country:

Contact Phone Number*

Work

Mobile

Email Address*

Confirm Email Address*

Assessment Number

Property Address

Street Address:

City:

State:

Post Code:

Country:

Please register me for emailed Rates Notice*

Yes

I agree to notify Council if the email address changes from the existing address*

Yes

I understand that a hard (paper) copy will not be mailed out to me*

Yes

I confirm that I have read and accepted the terms and conditions of this service*

Yes