Pensioner Rebate

                                                                                                   Application for rate concession

Queensland government pensioner rate subsidy scheme and council pensioner concession policy
                                              *Please Complete all questions *
1. Property Details
A. Rate Property Number
B. Address of Property


Suburb                                                        State QLD                               Postcode

2. Applicant Details
A. Full Given and Surname of Applicant/s      B. Pension Card Numbers                                                C. Card Start Date




D. Current Residential Address                                                          “As Above” if the postal same as your property address

     Suburb                                                   State                                   Postcode
E. Current Postal Address                                                               “As Above” if the postal same as your residential address

     Suburb                                                   State                                   Postcode
F. Are the above address details the same for each owner?                         Yes            No      Provide details at 3.F below
                                                  Tick the relevant box

G. Do you own any other properties in the NSC area?                               No             Yes     Provide details at 3.F below
                                                  Tick the relevant box

H. Home phone                                                        I.   Mobile
                                                                          Name
J.   Email address                                                                       K. Work phone
     Name                                                                                   Name
                       Council will update your record with the contact details you provide on this form

3. Property Information
A. Is this property your principal place of residence? If no, please state why:                                            Yes             No


B. Please state the date of occupancy                                                                    Date:
C. Please list all owners of the property and their relationship to the applicant:
     •    Name:                                               __ Relationship:                                                             _


     •    Name:                                                   Relationship:                                                            _

D. Are you a Life Tenant? (please read information about life tenancy guidelines on page 3)                                Yes              No

E. Are you solely responsible for the payment of rates?
                                                                                                                           Yes              No
F. Additional Information:




Digital Pension Cards: Card Start date:                                            Digital card sighted by CSO:
Additional names:



 NOOSA COUNCIL                   PO Box 141                P. (07) 5329 6500                 [email protected]
 ABN 97 969 214 121              TEWANTIN QLD 4565         F. (07) 5329 6501                 www.noosa.qld.gov.au