Information and declaration

Rate Payment Arrangement Application

Read before you start your application

Residential applicants can use this form to apply for a payment plan for rates. As part of this application you may need to provide some supporting documentation.

You can check the Rates Hardship web page for more information about this process and eligibility. You can also read the Rates Hardship Policy (DOC 373KB).

Please note

Contact the Rates Department on 03 9209 6777 or submit a question online to discuss options if you're:

a commercial investment property owner
residential investment property owner
commercial tenant
a residential owner/occupier seeking a deferment or waiver.

Please allow 15 business days for assessment of your application.

A copy of our privacy policy is available on our website.

Declaration

I am the property owner *

This application is for my principal place of residence *

By submitting this form I agree to the payment options and conditions under Council’s Financial Hardship Policy (Rates and Charges) and that my application is subject to approval *

Please indicate whether any of the following apply to you:

Residential ratepayers that are current recipients of the DFFH Utility Relief Grant Scheme (copy of DFFH approval letter must be attached to this application) Very low-income earner who can show that you have no way of paying the account without assistanceYou or someone in your house has experienced family violenceYou have had a recent decrease in income, for example, loss of employmentYou have had high unexpected costs for essential itemsThe cost of housing is more than 30% of your household income

Assessment details

Assessment number (refer to Rate notice) *

Applicant category *

PersonalCompany

Do you own another property or properties? *

YesNo

Please provide the assessment numbers *

Applicant details

Company applicant

Applications must be made by the company director/s or their authorised agent (eg: accountant or financial advisor).

Company director's first and last name *

Company name/ACN *

Company director's mobile number *

Company director's email *

The applicant is: *

Company directorAuthorised agent

Name of authorised agent *

Authorised agent's company *

Authorised agent's contact number *

Authorised agent's email *

Please provide written confirmation from the company director authorising the agent to make the application on their behalf *

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Max file size 50MB

Personal applicant

Property owner's first name *

Property owner's last name *

Property owner's date of birth *Date of birth is needed to verify your ID

Property owner email *

Property owner contact number (please enter without spaces) *

Please provide your preferred email and phone number as we may need to get in touch with you to discuss your application.

Mailing address

Property address

Street address *Include unit number if applicable

Suburb *

Postcode *

Is your mailing address the same as the property address? *

YesNo

PO Box number *

Suburb *

Postcode *

Assistance request and lodgement

Assistance request

All requests for assistance are subject to Council approval.

You can use this form to request a rate payment arrangement up to 31 December 2025. The arrangement will include any arrears balance and the 2024/25 rates and charges. Interest charges do not apply on active payment plans.

Please provide total outstanding rates and charges amount as displayed on your most recent rates notice. *

Payment frequency - please note the total outstanding amount shown above must be paid in full by 31 December 2025 *

Proposed payment amount (weekly) *

Proposed payment amount (fortnightly) *

Proposed payment amount (monthly) *

The minimum repayment is $25

The minimum repayment is $200

Commencement date *Please note that you will need to commence your plan within 28 days of approval.

Please note: Supporting documentation may be requested by the reviewing officer.

Declaration and lodgement

Declaration

I understand that Council can request evidence supporting this application if the payment proposal falls outside the allowed timeframe. *

I understand that there are penalties if the information I provide is false of misleading. *

Data privacy and collection

The personal information requested on this form is being collected by the City of Port Phillip (CoPP) and will be handled in accordance with the Privacy and Data Protection Act 2014. This information will be used solely by the council for that primary purpose or directly related purposes. It will be treated in compliance with the CoPP Information Privacy Policy and the Information Privacy Act.

Yes, I give permission for the City of Port Phillip to store and process my data. *

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