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Online Form - Home Safety and Security Rebate Scheme

Please click here to access the Town's Creditor form. Please complete this form and submit via the last question on this form.

Please upload proof of the below via file uploads

Full Name *

Contact Number *

WA Seniors Card *

Maximum size of ALL attachments is 976.56 MB

Proof of Address *

Maximum size of ALL attachments is 976.56 MB

Proof of accessing the State Government's Seniors Safety and Security Rebate *

Maximum size of ALL attachments is 976.56 MB

Receipt from purchase *

Maximum size of ALL attachments is 976.56 MB

Receipt from installation

Maximum size of ALL attachments is 976.56 MB

Proof CCTV System is registered with CAM-Map WA

Maximum size of ALL attachments is 976.56 MB

Proof of Ownership of house / Consent Form from Ratepayer of Property *

Maximum size of ALL attachments is 976.56 MB

Completed Town Creditor Form *

Maximum size of ALL attachments is 976.56 MB