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= Required Fields

Online Form - Bin Request Application

This form must be completed by the owner of the property, or an authorised party (i.e. Real Estate Agent) only.

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.

Email Address:

Password:

Note: Incomplete forms are kept for a period of 2 day(s) hour(s), after this time the system will automatically delete your response.

Applicant Name / Company Name *

Is the applicant the property owner or the property owners' authorised person/company?

YesNo

Is the Owner Name as above?

YesNo

Is the Occupier Name as above?

YesNo

Address

Street Address:

City:

State:

Post Code:

Country:

Contact Number

Lot Number (if known)

Assessment Number (if known)

Number of Bin's Currently *

Updated Number of Bin's *

Number of Collections Per Week Currently *

Updated Number of Collection's Per Week *

Does the Bin Require Repairs *

YesNo

New Bin - please select the option that best describes your situation

Please Provide Relevant Details For New Bin Application

New Bin Sticker *

Please Provide Reason for Requiring New Sticker *

*Please see the Shires current Fees and Charges.

Please type your name below to signify that you agree that all information given above is true and correct at the time of submission *

Type the code from the image

Save & Exit