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

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