Right to Information Access
Application Form
Form 1
Please read the following information carefully before proceeding with your application.
The purpose of this form is to allow applications for information under the
Right to Information Act 2009 (RTI Act).
Before filling out the form, check with the
RTI officer of the agency you want to apply to, as the information you
need might already be available online, for purchase, or by request. For a list of departmental RTI officers visit:
www.rti.qld.gov.au/rti-ip-agency-contacts.
This form is also available online at
www.rti.qld.gov.au should you wish to download and complete electronically.
Some agencies also have their own forms, but using one is optional. You may also use this form to apply to Ministers.
For general information about the RTI application process, visit:
www.rti.qld.gov.au.
Fees and Charges
No application fee is needed if you are only applying for documents which contain your personal information. Access
charges may apply. Other applications will require an application fee. There may be processing and/or access charges.
Fees and charges may change. Contact the agency, or visit:
www.rti.qld.gov.au/fees-and-charges.
Each application needs a separate form. Fees may apply to each application.
Note:
you must fill in fields with this symbol.
Contact Details
Please provide your name and contact information, like a phone number, email, or address to which notices may be sent.
If you are applying for someone else, use your own contact details here. This information will help us to deal with
your application.
Title (Optional – e.g., Mr, Mrs, Ms, Miss, Other) Given name/s
Family name
Organisation name (Optional – see question 2. Complete if you are making this application on behalf of an organisation)
Postal address
Postcode
Preferred method of contact (Please indicate in order of preference, your preferred method of contact and provide relevant
contact details below. If you choose email or post, please also provide a telephone number. If you choose to give us an email for
communications, you might be consenting to your personal information being stored or processed outside Australia. If this is a
concern, provide a postal address).
Phone
Fax
Mobile
Email
Post
Application details
1. Which description most closely describes your application for access?
a.
All the documents I’m applying for contain my personal information OR I’m seeking access on someone else’s behalf,
and all the documents contain that person’s personal information –
no application fee.
b.
Some of the documents I’m applying for do not contain my personal information OR I’m seeking access on someone
else’s behalf, and some of the documents do not contain that person’s personal information –
you must pay an
application fee.
c.
None of the documents I’m applying for contain my personal information OR I’m seeking access on someone else’s
behalf, and none of the documents contain that person’s personal information –
you must pay an application fee.
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2. Are you seeking access to information on behalf of another person or an organisation?
No
Yes
Given name/s
Family name
Organisation name
Attach evidence of your authorisation to act on the person’s behalf.
(for example: a client agreement if you are a solicitor or written authorisation from the person concerned).
3. Which Queensland Government agency or Minister are you applying to?
4. Particular details:
Provide specific and detailed information about the documents you are seeking to access.
a. What the documents are about (e.g. the planning process for the Letter Z Program)
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b. The type of documents (e.g. internal memos, emails)
c. The date range for the documents (e.g. September 2024 – June 2025)
d. Document reference numbers (if known)
e. Where you think the documents may be located (e.g. Minister’s Office, facility, business area, unit, person)
f. Any other details you think will help us in dealing with your application (e.g. date of birth – please provide below or
as an attachment to your application).
5. Preferred access type (choose one):
Note: If you choose to access documents by email, CD, DVD or via a link there will be no charge for this access. If you require
a link to download documents note that not all agencies can provide documents this way. If your preferred form of access isn’t
available, the agency will let you know.
Inspect document/s
Photocopy of document/s
(charges may apply)
Document/s sent to me by email
Copy of the document/s on DVD
Copy of the document/s on CD
Download link
Note: If you receive documents by email, your information could go through overseas servers. If you are not comfortable with
this, please request another access type.
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6. Evidence of identity
To apply for documents which contain your personal information, you must provide evidence of your ID, either when
you apply or shortly after. If you are applying for documents for someone else and the documents contain their personal
information, you need to show you are allowed to do this by providing evidence of your authorisation to act on that
person’s behalf. You will also need to provide evidence of the person’s ID.
Applying:
by post – include the completed application form and, if required, a certified copy of ID and the agent authority.
in person – deliver the application and, if required, show original ID and agent authority to the RTI officer.
by email or fax – email or fax the application form and, if required, a certified copy of ID and the agent authority.
Note: Copies of some documents must be certified by a lawyer or notary public, a pharmacist, a commissioner for declarations or
a justice of the peace, and not all agencies accept applications by email – check with the agency you’re applying to.
Note: Examples of documents that may provide sufficient evidence of identity include:
current driver’s licence
copy of a prisoner’s identity card certified by a corrective services officer
digital driver’s licence
statutory declaration of an individual who has known the applicant for at least one
current passport
year.
(A statutory declaration form can be downloaded at
birth certificate
www.publications.qld.gov.au/dataset/statutory-declaration-affidavit)
7. Financial hardship
Concession card holders – To apply for a fee waiver due to financial hardship, you must write to the agency.
If you have a valid concession card, either show it to the RTI officer or attach a copy to your application.
Three concession cards are accepted:
a Health Care Card
a Pensioner Concession Card
a Veterans’ Affairs Pensioner Concession Card.
Note: Confirm with the RTI officer if your concession card is valid.
Non-profit organisations – If you’ve been granted financial hardship status, give the RTI officer a copy of the confirmation
from the Office of the Information Commissioner.
Note: Non-profit organisations must wait for the Office of the Information Commissioner to approve financial hardship status
before applying. If approved, the status lasts one year unless your financial situation significantly improves.
8. Payment of application fee
Confirm with the agency you’re applying to how you should pay your application fee.
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Declaration
Collection Notice: The information you provide on this form will be used to communicate with you and process
your application. Your information may be shared within the agency, with another agency if they are processing your
application, with consulted entities to obtain their views or with the Office of the Information Commissioner. Collection of
the personal information on this form is required by or authorised under the
Right to Information Act 2009.
Without enough personal details, we may not be able to contact you to discuss your application and you may not get all
the documents you are entitled to. Please note that your information will be dealt with under the Queensland Privacy
Principles (QPPs) as outlined in the
Information Privacy Act 2009 (IP Act). Each agency or Minister has a QPP Privacy Policy,
which contains information on how you may otherwise access your personal information, seek correction of your personal
information, or complain about a breach of the QPPs, or a QPP code under the IP Act. For Ministers’ QPP policies, please
visit
https://cabinet.qld.gov.au/ministers-portfolios.aspx.
If an agency or Minister gives you access to a document, and if the document contains no personal information about
you, a copy of the document may be published in a disclosure log or details identifying the document and the way the
document may be accessed may be included in a disclosure log.
By signing this form, I declare that:
The information provided in this form is complete and correct
I have read the collection notice
Where applicable, I have attached documents required for the purpose of this application
(e.g. evidence of identity, agent authority, evidence of financial hardship status)
If I cannot attach any required copies of documents, I will provide them to the agency as soon as possible after making
the application
I have included the relevant application fee (fee is base
d on the type of application, see question 1)
I understand that under s 176, it is an offence to give misleading information about my identity, and that doing so
may result in a decision to refuse to process my application.
Signature
Date
/
/
Office use only
Date received
/
/
RTI Ref
Application fee received
No
Yes
Date
/
/
Satisfied as to Identity of Applicant
No
Yes
Date
/
/
Identity Document Sighted
No
Yes
Date
/
/
Receiving Officer (print name)
Decision Maker Assigned to Application (print name)
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