Online Form - Financial Hardship Application

Ratepayers or Debtors experiencing financial hardship may be able to access relief from City of Busselton in the areas of rates, service charges, leases and or rental charges owed to the City from commercial or residential tenancy agreements and any other debt arising from a fee, interest or charge levied by the City. To determine whether you are eligible for consideration and to find out more about the application process, please view the FAQs below.

(Please complete this application in full.)

Save Your Progress

You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Note: Incomplete forms are kept for a period of 14 day(s), after this time the system will automatically delete your response.

Is this application being lodged on behalf of a Corporate/ Community Organisation/ Body/ Group/ Club/ Business?*

Financial Hardship Details

Indicate the number of properties that you're seeking financial hardship for in the following categories (ie, 0/ 1/ 2/ 3/ 3+)

Which of the following are you in relation to the properties on this application?*

Confirm what capacity you are seeking financial hardship*

Additional Information & Confirmation

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx
Are you aware that there are other assistance programs available from the State and Federal Governments?


I declare that the information I have provided in this application is correct and I am the authorised person by all owners or lessees or the organisation/body/group/club/business to lodge this application. I understand that should these statements and answers be untrue that the City of Busselton reserves the right to retrospectively revoke all waivers, discounts and assistance provided.*

Get Audio Code

Save & Exit