Authorisation for Electronic Delivery

If you chose to receive all your future correspondence from council via email, please complete the form below.

Details

Debtor Number *

Debtor Name *

Contact Name *

Contact Phone Number *

Preferred Email Address *

Declaration

I hereby authorise Hornsby Shire Council to send Council correspondence and communication to me via this email. This authorisation excludes emailing of Rate and Instalment Notices as this service is provided by a third party. *

Person signing this document is the account holder or authorised representative of the Business. *

Signature *

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Date *

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