Pension and Health Care Card Holder Application for Rates Remission 2026/2027 Rates

This form is required to be completed and received by Council by 31st March 2027 to be eligible for remission for 2026/2027 Rates.

Forms not received prior to the First Instalment due date will incur the relevant interest/penalty calculated on the total amount outstanding.

**A copy of your Pensioner Concession or Health Care Card both front and back must be uploaded **

Were you in receipt of a Pensioner or Health Care Card or DVA Card (endorsed TPI or War Widow/Widower as at 1st July 2026)? *

YesNo

Were you partly or wholly liable for the rates on the above property? *

YesNo

As you have answered no to this question. You are not entitled to a Pension Remission for the current financial year.

Was this property your principal place of residence as at 1st July 2026? *

YesNo

Is this the only property you have sought a remission on for this financial year? *

YesNo

As you have answered no to this question. You are not entitled to a Pension Remission for the current financial year.

Name on Concession Card *

Concession Number *

Issue Date *

Expiry Date *

As the date you entered as after 1st July 2026. You are not eligable for a Pension Remission for the 2026/2027 Financial Year

Property Assessment Number *

Ratepayer/s Name (In Full) *

Property Address Details

Address 1 * Street/Road Number and Street/Road Name

Address 2Other Eg. Property Name

Town/Suburb *

State *

Postcode *

Is your postal address different to your Property Address *

YesNo

Address 1 Street/Road Number and Street/Road Name or P O Box

Town/Suburb

State

Postcode *

Contact Phone Number *

Email Address *

Do you have a TasWater Connection? *

YesNo

Declaration I (insert Full Name) *

Authorise the Southern Midlands Council (the Council) and the Department of Treasury and Finance (Treasury) to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs Customer details and concession card status to enable the Council and Treasury to determine if I qualify for a concession, rebate or service.
Services Australia (the agency) to provide the results of that enquiry to the Council.

I understand that:

The agency will disclose personal information to the Council and Treasury including my name/address/ payment type/ payment status and concession card type and status to confirm my eligibility for a rates remission;
This consent, once signed, remains valid while I am a customer of Council unless I withdraw it by contacting the Council or the agency. I can get proof of my circumstances/details from the agency and provide it to the Council and Treasury so my eligibility for a rates remission can be determined.
If I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the rates remission provided by the Council and Treasury.

Signature *

Draw signature|Type signatureClear

Before me (Witness Signature) *

Draw signature|Type signatureClear

Dated *

Copy of Concession Card *

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Upload a copy of the front and back of your concession card

Maximum remission:

$401 for those pensioners that are a customer of a water corporation; or

$591 for those pensioners who are not a customer of a water corporation