Pensioner Rate Remission

Form

Notes

Please complete this form to apply for a pensioner rate remission.

To be eligible for a rate remission you must be the holder of a concession card on the 1st of July of the financial year to which the rates apply.

If you are having difficulty completing this form, please contact us on (03) 6397 7303.

Concession Details

Applicant Details

Property Details

Authorisation and Consent

The Northern Midlands Council (the Council) and the Department of Treasury and Finance (Treasury) to use Centrelink Confirmation eServices and perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs Customer details and concession card status to enable the Council and Treasury to determine if I qualify for a concession, rebate or service.

Services Australia (the agency) to provide the results of that enquiry to the Council and Treasury.

The agency will disclose personal information to the Council and Treasury including my name, address, payment type, payment status and concession card type and status to confirm my eligibility for rates remission.

This consent, once signed, remains valid while I am a customer of the council unless I withdraw it by contacting the council or the agency.

I can obtain proof of my circumstances/details from the agency and provide it to the council and Treasury so that my eligibility for rates remission can be determined.

If I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the rates remission provided by the Council and Treasury.

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