Rates, Fees and Charges Exemption from Rates and Charges Application Form Details of the Property Assessment Number Applicant Name Address of Property Address Address 2 City/Town ZIP/Postal Code Identification/Description of the Land eg: Lot & DP (deposited plan) Information to Assess your Application This Application is made under Section 555 OR Section 556 of the Local Government Act, 1993 555* *legislation.nsw.gov.au/#/view/act/1993/30/chap15/part6/sec555 556* *legislation.nsw.gov.au/#/view/act/1993/30/chap15/part6/sec556 Reasons for your request to be exempt from Rates & Charges Please attach copies of the following documents: Copy of Memorandum/Constitution or Articles of Association OR Documentation stating the organisation is a Government Body & Audited copy of the last two years financial statements Upload Upload requirementsMaximum 3 files.10 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Details of Applicant or Responsible Officer Name Position in Organisation Contact Number Submit Was this page helpful to you? Yes No Submit