Online Form - Financial Hardship Application

The Shire of Denmark recognises that at times there could be cases of genuine financial hardship, where debtors (sundry and rates) will experience difficulty in paying fees, rates and service charges as they fall due. The Shire of Denmark has adopted a Financial Hardship Policy and this applies to all debtors (sundry and rates) experiencing genuine financial hardship in relation to:

  • Outstanding fees, rates and services; and 
  • Future fees, rates and service charges levied.
Postal Address Same as Above?*
Is this application being lodged on behalf of a Body Corporate or community organisation?*

Max File Size: 10.00 MB
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Declaration: By submitting this document, the applicant/s understand that they are hereby declaring that they are experiencing financial hardship, are not bankrupt or subject to a bankruptcy petition and will advise the Shire of Denmark if there is any change to their financial circumstances.*