Apply for Rates Assistance due to COVID19

APPLICANT
Enter your full name
RadDatePicker
RadDatePicker
Open the calendar popup.
Enter your postal address
Enter your Contact Number
Enter your email address
RATES OWING
Enter the property address
Enter your properties assessment number
Enter the total amount owing on your Rates
REASON FOR APPLICATION
Why are you applying for financial assistance?
PAYMENT OF RATES
What is the estimated date you can pay your full rates by?
RadDatePicker
RadDatePicker
Open the calendar popup.
I would like to make a payment arrangement, I can pay:
How often can you make a payment?


How much would you like to pay per payment
Do you have the ability to pay by other means?
SIGNED
By entering your name here you are signing this application
Date of Application
RadDatePicker
RadDatePicker
Open the calendar popup.