New Rates and Water Direct Debit request

NOTE: Please complete a new form for each property for which you wish to establish a direct debit arrangement.

Property details

Assessment number *Your assessment number can be found at the top right corner of your rates or water notice.

Property owner name *

Property address *

Contact information

Contact name *

Contact email *

Phone *

Bank account details

Please note: credit cards are not accepted for Direct Debit payments.

Account name *

Bank and branch *

BSB *

Account number *

Payment schedule

Refer to the Direct Debit calendar (PDF) for extraction dates.

Please note: It may take up to five (5) working days to process this request. We recommend you submit this form to Council five (5) business days prior to the next direct debit extract calendar date.

Rates payment schedule

Payment in full (due date on Rates notice)Weekly (Monday)Fortnightly (Tuesday)Monthly (3rd Wednesday)N/A

Rate payment amount $ *

Start my Rates direct debit on the next scheduled date (weekly, fortnightly or monthly) as shown on the Direct Debit Calendar: *

after this dated agreementafter a specified date

Direct debit to start after this date: *

Water payment schedule

Payment in full (Friday after due date on water notice)Weekly (Monday)Fortnightly (Tuesday)N/A

Refer to the calendar for extraction dates.

Water payment amount $ *

Start my Water direct debit on the next scheduled date (weekly, fortnightly or monthly) as shown on the Direct Debit Calendar: *

after this dated agreementafter a specified date

Water direct debit start date *

Declaration

I/we authorise Cairns Regional Council (User ID 089-121) to arrange for funds to be debited from my/our nominated bank account at the financial institution identified above through the Bulk Electronic Clearing System (BECS).
I/we agree to the Service Agreement which I/we have read and understood. *

This agreement will remain in force in accordance with the terms described in the Service Agreement.

Information privacy statement

We are collecting your information for the purpose of direct debit applications. This is authorised under the Australian Payments Clearing Association and handled in accordance with the Information Privacy Act 2009.

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