Trying to register a new prepay for my father and the customer survey page won't complete. I fill in the details on the first screen and it comes back with an error requesting information for fields that aren't on the displayed form

Please complete the field 'Street Name'

Please select an item for 'Street Type'

Please complete the field 'Street Number'

Please complete the field 'Suburb/Town'

Now I've tried the page out under 3 different browsers just to make sure it wasn't a firefox issue.

Anyone else seen this issue?