Rates water refund transfer

I want to request a *

Refund of rates or waterTransfer of credit between rates and water accounts

NOTE: refunds/ transfers can only be facilitated where the account is in credit or the monies were not intended for payment to Council eg incorrect biller code. Forms must be submitted by close of business Thursday to ensure processing for the following Wednesday.

Property details

Assessment No. *

Property owner's full name *

Property address *

Contact information

Contact name *

Postal address *

Preferred contact method *

EmailPhone

Email Address *

Daytime phone number *

Refund

Refund of *

RatesWater

Amount - rates $ *

Amount - water $ *

Account name *

Bank & Branch *

BSB *Enter your BSB in the format xxx-xxx. Include the dash after the first 3 digits, and no spaces.

Account number *

Transfer

Transfer amount $ *

Transfer FROM my *

RatesWater

Paid against Assessment No *

Transfer TO my *

RatesWater

Transfer TO Assessment No. *

Same assessment numbers?

Are you the registered owner or authorised representative of both properties? *

YesNo

Proof of payment

Do you have a Direct Debit arrangement with Council? This is where funds are extracted by Council from your nominated bank account; it is not a recurring BPay payment through your financial institution. *

YesNo

NOTE: Proof of Payment for Refunds is an audit requirement. Proof (eg. copy of bank statement, B-pay transaction, Australia Post or Council receipt) must be submitted with this form unless a Council direct debit is in place.

NOTE: Proof of Payment is an audit requirement. Proof (eg. copy of bank statement, B-pay transaction, Australia Post or Council receipt) must be submitted with this form unless a Council direct debit is in place .

Attach proof of payment for refund *

Browse

Attach proof of payment for Transfer *

Browse

Eg copy of bank statement, B-pay transaction, Australia Post or Council receipt.

Declaration

I confirm that I am the registered owner or authorised representative of the property listed above and authorise this refund/transfer of funds. *

Cairns Regional Council – Information Privacy Statement

Your personal information has been collected for the purpose refunding and/or transferring a rates and water usage payment. You are providing personal information which will be used for the purpose of delivering services and carrying out council business. Your personal information is handled in accordance with the Information Privacy Act 2009 and will be accessed by persons who have been authorised to do so. Your information will not be given to any other person or agency unless you have given us permission or the disclosure is required by law.