I/We notify the Council that the second dwelling/residence on my/our property described below is not let or available to be let.

Fill out the PDF version [PDF, 245 KB].

Property Details
Type your name here to give authority for this Declaration.

Please ensure the declaration is fully completed and signed, and retured to us before 12 June.

Declaration
Please do not give any false information. This is an offence and you may lose any benefit from this policy. * Any changes to the occupancy during a rating year will affect the rates from the commencement of the next rating year.
Type your name here to give authority for this Declaration

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You can read the full policy at selwyn.govt.nz/privacy.

We will use the email address you provide to send communications directly related to this form or application. By submitting this form, you consent to receive those communications by email. If you require a hard copy, please email ContactUs@selwyn.govt.nz, visit our Service Desk Team or call 0800 SELWYN (735 996).