Download Request to replace a stolen wheelie bin

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33-Fmx-167 | Version 06/07/2016
Page 1 of 2
Request to replace a stolen wheelie bin
The charge to replace a wheelie bin is $80.00 for a 140L bin and $85.00 for a 240L bin. However, if you
have had your wheelie bin stolen on your collection day Council will replace your bin free of charge on the
first occurrence. To apply for a replacement bin, free of charge, please complete all details below. Please
allow 10 working days for delivery of your new bin.
Please print
Title
Given Name/s
Surname
Date of Birth
Unit/Street No
|
|
Street
Suburb
State
Postcode
State
Postcode
Postal Address (if different from street address)
Suburb
Phone
H
B
M
Email
Type of Wheelie Bin Stolen
Waste
Size of Stolen Wheelie Bin
Normal Collection Day
85L
M
T
Date Wheelie Bin was First Noticed Missing
Recycling
140L
W
240L
T
F
/
/
I declare that details above are true and correct. To the best of my knowledge the bin was stolen on my
collection day. I understand that if I recover my original bin that I must contact Council to have the duplicate
bin removed. If I am found to be ineligible for a replacement bin free of charge I understand that I may be
requested to pay the replacement fee.
Your Signature
Date
/
/
Please return your completed form to Council by email or post; or you may drop it directly in to the
Customer Service Centre in the Town Hall.
33-Fmx-167 | Version 06/07/2016
Page 2 of 2
Personal Information Protection Statement
As required under the Personal Information Protection Act 2004
1.
Personal information is managed in accordance with the Personal Information Protection Act 2004 and may be
accessed by the individual to whom it relates, on request to Launceston City Council.
2.
Information can be used for other purposes permitted by the Local Government Act 1993 and regulations made
by or under that Act, and, if necessary, may be disclosed to other public sector bodies, agents or contractors of
Launceston City Council, in accordance with Council's Personal Information Protection Policy (17-Plx-005).
3.
Failure to provide this information may result in your application not being able to be accepted or processed.
Action Officer
Customer Service Centre
TechOne Property No.
Collection Day Checked
Bin Type & Size Checked
Stolen Date Checked
Previous Requests
Approved with No Charge
Receipt No. (if charged)
Toxfree Notified
TechOne Updated
CSC Initials
ECM Register the property
number
CITY OF LAUNCESTON - Request to replace a stolen wheelie bin
Date Received