Customer Request Management Entry

Instructions

You are a member of the public, please fill this form in.

Change of name or postal address

Policy

Enter Details of Request *

Enter a description of events/problem.

Customer Details *

Customer

Name

Title

Surname / Company

Given

Contact Details

Residential address

Street address

Street address 2

Street address 3

Street address 4

Street address 5

Postcode

Postal address if different from residential

Street address

Street address 2

Street address 3

Street address 4

Street address 5

Postcode

Work

Home Phone

Mobile

Fax

Contact By

Not required

Telephone

I would like to: (Required)

Assessment number

Property Address Details

Search for the property the call is in relation to.

Building

Unit

Level Number

House

Street Name (without type)

Suburb

Title Type

Title 1

Title 2

Title 3

Title 4

Title 5

Title 6

Advanced search

Street Location Details

Select a Suburb and Street the call is in relation to.

Select Street

Select Suburb

Additional Location Description

Enter a description of the location related to the call.

Description

If you have selected 'Update my name (proof provided)', please upload the relevant proof

Upload an attachment from your computer to link to this call.

I acknowledge that I have read and understood the instructions / conditions linked above. (Required)

I declare that the information I have provided in this form is true, correct, and complete to the best of my knowledge. I understand that providing false or misleading information may result in penalties under applicable laws. (Required)

/eservice