NRUPP - payment nomination form

Assessment number (refer to letter)*

Property address (refer to letter)

Street Address:*

City:*

State:*

Post Code:*

Country:*

Company name (if applicable)

Title*

First name*

Last name*

Phone*

Email*

Please tick the option to be charged on the annual rate notice.*

Single payment
Seven annual instalments

I/We acknowledge the instalment contribution, and that the balance will need to be paid at settlement, should the ownership of my property change.*

I/we acknowledge

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