* Denotes that the field is mandatory.
Assessment Number *
Property Address *
Do you own other property other than the one listed above, in the City of Belmont?
If Yes, Please list here...
Mailing Address *
PO Box Address (if applicable)
Does the new address apply to all owners?
If no, which owners are changing?
Name of person completing this form? *
Daytime phone *
Mobile *
Email address *
Are you registered for eRates? *
If Yes, do you want your eRates information updated?
Date (eg DD/MM/YYYY) *
Do you wish to be notified of any outstanding balances on the above listed accounts?