Rates Lump Sum Payment
Penalty Remission
Application Form
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
Section A - Applicant Information
Ratepayer Name(s):
Postal Address:
Street address or PO Box number:
Suburb or RD:
Town or City: Postcode:
Contact Phone Number(s): Home Work
Email: Mobile:
Section B - Property Information
Valuation Number:
Property Legal Description:
Property Location:
Section C - Payment Details
Balance Outstanding: Rates Balance:
Penalty Balance:
Proposed Repayment Amount:
Proposed Date to Repay Balance:
327177 : 003/004 : RR17
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
Section D - Customer Circumstances
Please provide a brief overview in the space below, describing how and why your rates
have escalated to the current rates arrears balance: (attach additional pages if required)
Section E - Rates Lump Sum Payment Conditions
• I/We understand and agree to the conditions outlined above.
• I/We agree to meet the following payment offer and will adhere to it by the proposed
repayment date.
Ratepayer Name(s), please print:
Ratepayer Signature (for and on behalf of all owners):
Date:
Section F - Declaration (to be completed by the applicant)
Rates Lump Sum Payment
Penalty Remission
Application Form
Council will remit all the current and historic penalties on your rates account provided
you meet our requirements and approval of this application is granted by the Chief
Executive:
• No arrangements will be put in place until Council has received this completed signed
application form and a completed Easy Pay Direct Debit form.
• You agree to enter into Council’s Easy Pay Direct Debit scheme to repay current rates moving
forward.
• That the agreed proposed rates lump sum repayment amount is repaid by the proposed
repayment date.
• Should this arrangement be dishonoured at anytime, the agreement will be deemed void and
no penalties will be remitted.
• (If applicable), I am authorised to enter into this payment arrangement on behalf of all
owners of the property.
Waitomo District Council reserves the right to change the Rates Lump Sum Payment
Penalty Remission application conditions.
This application will be considered and the applicant will receive a written response
from Council about the outcome.
327177 : 003/004 : RR17
click to sign
signature
click to edit
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
What is a rates lump sum payment penalty remission?
We offer a formal rates lump payment option to ratepayers who can afford to repay their rates
arrears by a lump sum payment. If their application is approved Council will remit the current and
historic penalties on their rates account - leaving only the rates balance to repay.
You will need to complete and sign a Rates Lump Sum Payment Penalty remission application form and
an Easy Pay Direct Debit form and submit it to Council for consideration.
In accordance with the terms of this arrangement, we require you to enter into a direct debit
arrangement with Council to repay your current and future rates.
You can make these payments either on a weekly, fortnightly, monthly or quarterly basis.
Payments from your chosen bank account will be made on time, which means no penalties and no
dates to remember moving forward.
By honouring all your future direct debit payments - you will not have to worry about being in
arrears again.
The Council has been contacted to enquire about entering a rates lump sum payment arrangement.
A rates lump sum payment penalty remission form has been completed and returned to the
Council.
An Easy Pay Direct Debit application form has been completed and returned to Council.
Should you have any queries please phone 0800 932 4357
Our friendly Customer Services Team are here to help.
Rates Lump Sum Payment
Penalty Remission Guide
How do I go about entering into an arrangement with Council?
To obtain a copy of these forms please either contact our friendly Customer Services Team on
0800 932 4357tohavethemmailedtoyou,visitourCouncilOfcesonQueenStreet,TeKuiti
between Monday and Friday, 8am to 5pm. Alternatively, you can download a PDF of this form from our
website www.waitomo.govt.nz (the forms can be found under the rates section).
Why do I need to complete an Easy Pay Direct Debit form?
How do I make my lump sum payment?
Council will accept the following payment methods: Cash, Cheque, Eftpos, Credit Card
(excluding Amex or Diners Club Card) or dated cheques (to be presentable by the due date)
attheCouncilOfce.
Alternatively if paying by direct credit is an option for you, our bank account number is:
Westpac Bank: 03-0449-0070201-00
Please use your valuation number as the reference for direct credit payments.
Use this checklist as a guide to help you enter into a Rates Lump Sum Payment
Penalty Remission Arrangement
327177 : 003/004 : RR17
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