* Denotes that the field is mandatory.
City of Belmont eRates

Are you the Owner or the Agent of the Owner?
If you are an Agent, please attach authorisation document here *
If you are not the Owner or the Agent of the Owner you are ineligible to register
Assessment Number *
Property Address *
Name *
Postal Address *
eRates Email Address *
eRates Confirm Email Address *
eRates Mobile Number
(eg XXXX XXX XXX)
*