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Hardship Concession Application
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Hardship Concession Application If you have been severely impacted by hardship circumstances and are experiencing financial difficulties, please fill out this application form. For more information please see Council’s Rates and Charges Financial Hardship policy, available our website – www.noosa.qld.gov.au. 1. Property Details Rate Property Number Address of Property Suburb State QLD Postcode 2. Applicant details Name/s of owner/s who reside at the property Current residential address Suburb State Postcode Current postal address Write “As Above” if the same as your residential address Suburb State Postcode Are the above address details the same for each Yes No owner? Please provide details in Tick the relevant box section 4. Do you own any other properties in the Noosa area? Yes No Tick the relevant box Home phone Work phone Mobile Email address Fax Council will update your record with the contact details you provide on this form 3. Application details Please provide details of applicants holding any of the following current pension card/s: Pension Concession card issued by Centrelink? Department of Veteran Affairs or Repatriation Health (Gold) Card issued by Department of Veteran Affairs? Queensland Seniors Card issued by the Queensland State Government? Name of Applicant/s Pension Card Numbers Card Start Date Full or Partial Type 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
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Section 2
NOOSA COUNCIL 4. Please provide summary details to support your hardship application. 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
Section 3
Hardship Concession Application
5. Certification of applicant/s
Name/s of applicants:
Given Name/s Surname
Given Name/s Surname
Given Name/s Surname
I/we wish to apply for rates and charges relief based on financial hardship.
Relief requested (please select one).
▭ a 12-month (interest-free) payment plan which will see all overdue and upcoming rates paid within that
timeframe or
▭ a 2-year (interest-free) payment plan which will see all overdue and upcoming rates paid within that
timeframe.
(Note: to apply for this type of relief your application must be supported by a statement from a certified financial
counsellor.)
Information on where to access a financial counsellor can be found on the Australian Government website
www.afsa.gov.au/i-cant-pay-my-debts/support-services/where-find-help-managing-debts.
Reason for hardship:
▭ Loss of employment of the landowner or family member, or other critical financial situation.
▭ Family breakdown.
▭ Physical and mental health issues, including illness, physical incapacity or hospitalisation of the landowner, or
landowner’s family member.
▭ A disaster within the Noosa Council Local Government Area directly affecting the landowner.
▭ A death in the family of the landowner; or
▭ Other factors resulting in unforeseen change in the landowner’s capacity to meet their payment obligations,
whether through a reduction in income or through an increase in non-discretionary expenditure.
Please attach any supporting documentation you consider relevant. If you are unsure as to what documentation
to attach, please contact Council to discuss the matter.
Please note – Upon request Council may require you to provide additional documentary evidence to support
your application.
Signature Date
Signature Date
Signature Date
Terms and conditions of the Rates and Charges Financial Hardship Policy
To be eligible for relief based on financial hardship:
The applicant must be a sole or joint owner of the property.
The property must be the landowner’s principal place of residence.
The applicant must have legal responsibility for payment of the property’s rates and charges.
The landowner must provide sufficient information to demonstrate that they will suffer hardship if
required to pay rates and charges when due.
The property is not let, partially or fully, for either short- or long-term rental to derive income.
There is a demonstrated sound record of payment history for Council rates and charges.
The balance or amount payable exceeds $1,000.
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
Section 4
NOOSA COUNCIL
A landowner will not be eligible to make an application under this policy if:
They own more than one property in the Noosa Local Government Area.
Where Noosa Council has already commenced recovery action by either (a) referring the matter of the
outstanding rates to a debt recovery agency or (b) commencing action per section 140 of the Local
Government Regulation 2012 to sell land for overdue rates.
Discount
Where 5% discount is offered for prompt payment, discount will not apply to properties granted a hardship
concession.
Privacy
Council will use any personal information provided for the intended purpose only and for remaining in contact
with you. Council is authorised to collect this information in accordance with the Local Government Act 2009.
Your personal information is only accessed by persons authorised to do so. Your information will not be given
to any other person or agency unless you have given us permission, or we are required by law.
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