Reference Code:
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For enquiries relating to your Refund Application please contact Access Canberra on 13 22 81.
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Request Received

Refund Application
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Next steps

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Refund Application - Submission confirmation
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Access Canberra
ABN 16 479 763 216
GPO Box 158
Canberra City 2601
Telephone: 02 6207 1923

Request type

Refund Application
Fields marked with * are required

Staff member completing form

Individual or company requesting refund

Refund Application
Fields marked with * are required
Is the payer: *
Contact person

Postal address

Site details

Refund Application
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If you require help with suburb/district, section or block details, visit ACTMAPi.

Payment options

Refund Application
Fields marked with * are required
Would you like the refund to be paid by *

Postal address

Receipt
File:
Please note: An administration fee may be deducted from the refund. For administration fees, please refer to the current Fees and charges.
Administration fee applicable?
Has customer been notified?
Please contact client to advise prior to completing this form
Is the application for refund approved? *
Area

Delegate decision

Refund approved? *
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