Customer Request Form

* Mandatory Field

Customer Request Form

Please use the form below to advise Council of any requests/complaints you may have regarding Council services.

First Name*
Last Name*
Assessment Number (A....)

If regarding your property please fill in (located on your Council Rate Notice)

Street/ Lot/ Section Number*
Street Name*
Town*
Daytime Phone*
Mobile Phone
Email Address*
Details of the Request*

Please include as much detail as possible including location and service requested

If you see this, leave this form field blank.
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