Email My Rates

Save Your Progress

You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Email Address:

Password:

There is no way to resend or recover your password, please write it down.

Note: Incomplete forms are kept for a period of 7 day(s), after this time the system will automatically delete your response.

Privacy Collection Notice

The Shire of Denmark collects your personal information to deliver services and meet our legal obligations under relevant laws. When you provide your information on this form, your information is used by the Shire of Denmark and its contracted service provider (Forms Express) for the sole purpose of issuing rates notices to you electronically.

We handle your information in accordance with the Privacy and Responsible Information Sharing Act 2024 and other applicable legislation. Your information is stored securely and kept only as long as required. It may be shared internally at the Shire of Denmark to aid our customer service delivery and may be shared with other government agencies if required by law. If you do not provide your information, the Shire is unable to provide the Email My Rates Notice service to you.

You can request access to or correction of your personal information by contacting the Shire of Denmark Privacy Officer at info@denmark.wa.gov.au. For more information, visit www.denmark.wa.gov.au/privacy

Assessment Number*

First Name*

Surname/Company Name*

Property Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Postal Address

Postal Address:*

City:*

State:*

Post Code:*

Country:*

Email Address*

Phone Number*

Terms and Conditions Declaration*

I have read and agreed to the terms and conditions

Save & Exit