Form
FOI Request Application
APPLICANT NAME
_________________________________________________________
APPLICANT
ADDRESS
_________________________________________________________
_________________________________________________________
APPLICANT
ORGANISATION (IF
APPLICABLE)
APPLICANT
CONTACT
NUMBER(S)
APPLICANT EMAIL
ADDRESS
TYPE OF APPLICANT ■ Individual Representative
Other (please specify)
REPRESENTATIVE
NAME
REPRESENTATIVE
ORGANISATION (IF
APPLICABLE)
REPRESENTATVE
ADDRESS:
REPRESENTATIVE
CONTACT
NUMBER(S)
REPRESENTATIVE
EMAIL ADDRESS:
Form – Freedom of Information Request
1
RELATIONSHIP TO
APPLICANT
DOCUMENTS YOU ARE REQUESTING ACCESS TOO:
Please avoid using wording such as ‘al documents’ because your request may end up being too large for
the agency to process, or it may not be specific enough for the agency to identify the document(s). If you
are not sure how to frame your request, contact the VICSES Freedom of Information and Privacy Officer
(contact details at the end of the form)
TYPE OF DOCUMENT
REQUESTED (IF
KNOWN)
WHAT THE
DOCUMENT
RELATES TO
DATE (OR DATE
RANGE) IN WHICH
THE DOCUMENT MAY
HAVE BEEN
CREATED
THE TYPE OF
DOCUMENT YOU
SEEK
(for example, an
attendance report,
email(s) etc)
EXCLUDING DOCUMENTS OF INFORMATION YOU DON’T NEED.
It is helpful to exclude certain documents or information from your request if it isn’t particularly necessary or
relevant. This may al ow VICSES to process your request more quickly by potentially reducing the number
of documents to assess or removing the requirement for the agency to consult with third parties.
An third party might include volunteers; member of the public, members of other attending organisations
(e.g. Police, CFA; Ambulance), external organisations, private companies etc.
DO YOU REQUIRE ACCESS TO:
DRAFT DOCUMENTS Yes
■
No
DUPLICATE
DOCUMENTS
Yes
■
No
Form – Freedom of Information Request
2
PERSONAL OR
COMMERCIAL
Yes
INFORMATION
■
No
RELATING TO THIRD
PARTIES
ANY OTHER
RELEVANT
INFORMATION
Please forward your completed
FOI Request Form to the Freedom of Information and Privacy
Of icer by email to
xxx@xxx.xxx.xxx.xx (preferred) or send to:
Freedom of Information and Privacy Officer
168 Sturt Street,
Southbank VIC 3008
To be considered a valid FOI request payment must be made or proof of hardship must be
provided. Proof of hardship information will not be retained after it is viewed.
If you have any queries please do not hesitate to contact the Freedom of Information & Privacy
Of icer on (03) 9256 9000 or email
xxx@xxx.xxx.xxx.xx.
Form – Freedom of Information Request
3
Document Outline