Customer Request Management Entry

Instructions

Please complete the following form with as much details as you can to help us process your request in a timely manner. This form is only to be used for non-urgent requests. For any urgent or dangerous issues, please call (08) 9528 0333.

Please note that we take your privacy seriously and will not disclose your details to any third party without prior permission.

eRates Subscription

eRates Subscription   

Select the Rated Property this request applies too (If the property does not display please use "Advanced Search") (Required)

Search for the property the call is in relation to.

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Would you like to receive eRates Notices via email? (Required)

Please confirm your email address (Required)

Customer Details (Required)

Customer Details (Required)

Name

Name
'

Contact Details

Contact Details
Residential address

Residential address

Postal address if different from residential

Postal address if different from residential

What is the preferred method of receiving correspondence?

Other Contacts Add

Upload Attachments

Browse for an attachment to link to this call.

CRM to CRM

Link another Customer Request to this call.

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