Special Payment Arrangement Proposal and Direct Debit Application Form

Property and Owner Details

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Overdue Rating Balance Payment Proposal

The Pay My Rates page on the City of Busselton website contains further information about the different rates payment options.

https://www.busselton.wa.gov.au/council/rates/pay-my-rates.aspx

Please complete the below direct debit section and submit at least 2 working days before any payment date.

(a) Payments as proposed are to be made via Direct Debit by completing and submitting the below Direct Debit section at least 2 working days before the initial payment date.
(b) Payments should be met even where a decision on this proposal is yet to be received or the Direct Debit commences.
(c) Any approved proposal will be subject to various terms & conditions including:
* Accrual of interest on any rating arrears or overdue balance
* Charging to the property of the City's $35.00 special payment arrangement fee
* Cancellation of this arrangement where a payment is not met.

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Direct Debit Details

Please complete the below direct debit section and submit this form at least 2 working days before any payment date.

Direct Debits are only processed on Fridays (or the next business day).

By submitting this request, you agree to the Direct Debit Request Service Terms and Conditions here:

https://www.busselton.wa.gov.au/documents/12858/direct-debit-terms-and-conditions

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