Payment Arrangement Application

ABOUT THIS FORM

Council recognises there are cases of genuine financial hardship requiring respect and compassion in special circumstances. If you are unable to pay your rates by the due date, Council may approve a payment arrangement by accepting a regular periodical payment for a sepecified amount of time or until the oustanding balance is paid. The ratepayer must consider their personal financial circumstances, any future obligations and the overdue rates balance in order to meet the ongoing payment amount.

NOTES TO RATEPAYER

Submit one application for each rates account.
The ratepayer must calculate the amount of the arrangement in adherence with the conditions below whereby Council will accept all reasonable arrangements and will only contact the ratepayer if an adjustment to the amount is required in order to align with Council’s policy and guidelines.
The ratepayer must consider that new rates and charges will be issued by the end of July of each financial year.

CONDITIONS OF AGREEMENT

Applications will only be accepted if submitted by the property owner or an authorised third party already recognised by Council. (A third party may be specified at the time of application with the required documentation).
Any arrangement made before the due date of the 3rd instalment, should be made such that all amounts are paid in full by 30th June of that financial year.
Arrangements made after the 3rd instalment due date may extend into the following year however, must be reviewed once the subsequent year’s levy also becomes payable.
Payment arrangements are subject to Council’s Rates and Charges, Debt Recovery and Hardship Assistance Policy.
If the application for the payment arrangement is approved, any existing direct debit authority will be cancelled. A new Direct Debit Authority Request will be required if you wish to have your direct debit arrangement re-instated following the agreed arrangement period.
In accordance with Section 566 of the Local Government Act, 1993 (“the Act”), overdue rates and charges are subject to interest calculated daily.
If financial circumstances should cause the delay of any payment or the inability to maintain this arrangement you must notify Council immediately.
Failure to adhere to the agreed payment arrangement may result in the commencement of legal action without further notice.

PROPERTY DETAILS

Rates Account Number

Address *

Property_Key

Street

Suburb

Postcode

APPLICANT DETAILS

Are you the owner of the property? *

YesNo

Is the property Owner Company/Business? *

YesNo

Does council hold a written authorisation from the director of the company? *

YesNo

First Name *

Surname *

Company/Business Name *

Company/Business Phone *

Company/Business Email Address *

Company Authorisation Document *

Browse

Evidence of directorship or written authorisation from the director nominating the applicant as an authorised person.

Does council hold a written authorisation or authorised care of (c/-) instruction? *

YesNo

Authorisation Document *

Browse

A letter of authority is a document held on Council records that authorises a third party to act on behalf of the property owner. Council must have this document on record to process the application.

Email Address *

Phone (mobile preferred) *

DETAILS OF CIRCUMSTANCES *

DETAILS OF ARRANGEMENT

Arrangement Commencement Date *

Arrangement Amount *

Payment Frequency : (Please tick one option) *

WeeklyFortnightlyMonthly

DECLARATION

I agree to the terms and conditions as outlined in the Conditions of Agreement *

Full Name *

Applicant 1 Signature *

Draw signature|Type signatureClear

Date *

Privacy Statement :

In submitting this form, you consent to Council:

1. collecting your personal information as contained in the form; and

2. using the information for the purposes outlined in the form and for any other Council function.

Providing your information is voluntary. Should you choose not to provide the information, Council is unable to process your application/request.

You may access any of your personal information that Council holds upon request.