Special Arrangement Request

Special Arrangement Request
We can discuss an appropriate special arrangement payment plan that is better suited to your circumstances and in line with your income cycle, for example, weekly or fortnightly BPAY payments can be made to pay off your rates in smaller amounts.

If you would like to apply for a special arrangement, please complete the form below. You can estimate your repayments based on your personal circumstances. Once submitted, your request will be reviewed and actioned by a rates officer within 14 days.

Note that payment due dates and penalty interest still apply per the rates notice terms and conditions until your request is approved.
If you would like to apply for a special arrangement, please complete the form below, or contact the Shire’s Revenue Team at (08) 9780 5234 or revenue@amrshire.wa.gov.au
Contact Details
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Property address
Assessment number (if known)
See the example rates notice below in order to locate your assessment number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Special Arrangement Calculator
Repayment Schedule
Outstanding Balance
Weekly Repayment Start Date
Estimated Weekly Interest Per Payment
Estimated Weekly Repayment Amount
Fortnightly Repayment Start Date
Estimated Fortnightly Interest Per Payment
Estimated Fortnightly Repayment Amount
Monthly Repayment Start Date
Estimated Monthly Interest Per Payment
Estimated Monthly Repayment Amount
Proposed Repayment Amount
Minimum Number of Payments Required
Proposed Frequency
Days to Complete Payment
Current Date

MonthDayYear
Date
Cut Off Date

MonthDayYear
Date
Estimated Date for Final Payment
Total Interest
If the payment arrangement date has exceeded June 30 2025, a financial hardship form will need to be completed to enter into the proposed special arrangement request.
Special Arrangement Conditions
Please note that a special payment arrangement is not automatically accepted upon submission of this request form. Your request will be reviewed by a rates officer within 14 days.

The special arrangements will be calculated to start within 14 days from the date of application to the end of the current financial year.

Interest applies on approved special arrangements and is charged at the rate of 4.49% as adopted by Council. Eligible pensioners and seniors are exempt from instalment interest.

Default on the agreed arrangement may result in the referral of the debt to the Shire’s debt recovery agency without further notice to you.
Signature*

Clear
Should be Empty:

Special Arrangement Request

Contact Details

Property address

Special Arrangement Calculator

Special Arrangement Conditions