Customer Request Management Entry

Instructions

To help us process your request in a timely manner, please complete with as much detail as you can.
Registered users can track their requests through the account summary in their profile.

You will receive an email confirmation of your request after 5.30pm on the day of your submission.
If you submit after 5.30pm your confirmation email will be sent at 5.30pm the following day.


Collection of Information & Privacy Statement
The information collected in this application form is being collected by Council for reference and identification purposes. We will only use personal information provided by you for the purposes for which it was collected and in order for Council to fulfil its business requirements.
In accordance with our Privacy Policy we will not disclose your personal information without consent to a third party, institution or authority except where required by law or other regulation.

Deceased or Departed Animal

  

Customer Details *

Name

Contact Details

Residential address

Residential address

Postal address if different from residential

Postal address if different from residential

Contact By

/eservice