E- Rates Registration Privacy The Town of East Fremantle is collecting your personal information for the purpose of responding to your request. Some of the information may be provided to Town Contractor's for the purposes of addressing your request. Your information will not be provided to any other person or agency unless you have given us permission, or where legally obligated to do so. If you would like to know more about how the Town handles your personal information please see the Town's Privacy Statement and Collection Notice. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ Title*This field is required. Select an Option CO CR DR EST MISS MR MRS MS N REV U * Required Field. Given Name*This field is required. * Required Field. Surname / Company*This field is required. * Required Field. Date of birth (DD/MM/YYYY): * - Is the change for rates correspondence?*This field is required. YesNo Enter property assessment number: * Required Field. Does the address need to be updated for all property owners?*This field is required. YesNo * Required Field. Current Address*This field is required. * Required Field. New address*This field is required. * Required Field. Is your postal address the same as your new residential address:*This field is required. YesNo Please enter your postal address: * Required Field. Do you own another property within the Town of East Fremantle?*This field is required. YesNo Enter address here: * Required Field. Do you own a Dog or Cat that is registered with the Town of East Fremantle*This field is required. YesNo * Required Field. Email*This field is required. * Required Field.* Please enter a valid email address. Telephone number*This field is required. * Required Field. Additional Notes Upload File 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 Type the code from the image: The code you entered is not valid. Get Audio CodeType the code from the image