This form is to be completed if you require a rural rapid number. Residential dwellings, commercial business, workshop, dairy shed or any other regularly occupied building in the rural area need to have a rapid number so that emergency services can easily find you.

* = required field

Your Details

Request made by *
Your name and company name if you are requesting a number on behalf of the owner

Owners Name *
If property is owned by a trust please supply the trust name

Phone Number *
Cellphone or landline

Email Address

Property Details

Road Name of Property *

Vehicle Entrance Location

Legal Description of Property
If known - this can be found on your rate demand

Valuation Number
This can be found on your rate demand

Entrance Formed?

New or Damaged Post*

Please give us any other information or identifying features of your property also if the post is damaged the extent of the damage

Before submitting: Please ensure you have answered all questions.