This is an HTML version of an attachment to the Freedom of Information request 'Costs of street signs relating to parking'.


Government Information (Public Access) Act 2009  
ACCESS APPLICATION  
 
Please complete this form to apply for formal access to government information under the 
Government Information (Public Access) Act 2009 (the GIPA Act). For further information, please 
contact the Governance and Integrated Planning Division on 9369 8000 or visit our website at 
www.waverley.nsw.gov.au/your_council/Access_Council_Information. 
 
APPLICANT 
 
Title 
       Given Name/s 
 
 
 
 
   Family Name 
 
 
Organisation 
 
 
Postal Address   
 
 
 
 
 
 
 
 
 
 
  Postcode 
 
 
Daytime telephone       Facsimile 
       Email Address 
 
 
 
If you are acting on someone’s behalf please provide that person’s: 
 
Given Name/s   
 
 
 
 
       Family Name 
 
 
Please attach proof of your authorisation to act on the person’s behalf, such as legal documentation in support of your 
authority (for example: a client agreement if you are a solicitor) or written authorisation from the person concerned. 
 
PROOF OF IDENTITY 
 
Only required when an applicant is requesting information on their own behalf.  
 
When seeking access to personal information, an applicant must provide proof of identity in the form of a certified 
copy of any one of the following documents:  
 
 Australian driver’s licence (with photograph,       Current Australian Passport 
   Other proof of signature 
signature 
and 
current 
address)           
       and current address 
 
GOVERNMENT INFORMATION 
 
Please describe the information you would like to access in enough detail to allow us to identify it.  
Note: If you do not give enough details about the information, Council may refuse to process your application.  
 
   
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Are you seeking personal information?     
  Yes    
  No  
 
Third Party Consultation – 
Council may need to consult with other parties about the release of the information that 
you have requested.  Do you object to your name being released to these parties? 
 
  No, I have no objection to the release of my name  
 
 Yes, I object to the release of my name 

 
FORM OF ACCESS 
 
How do you wish to access the information?  
 
 Inspect the document(s) 




 A copy of the document(s) 

 Access in another way (please specify) 
 
DISCLOSURE LOG 
 
If the information sought is released to you and would be of interest to other members of the public, details about 
your application may be recorded in Council’s ‘disclosure log’. This is published on Council’s website.  
 
Do you object to this?    
 
   Yes  
 
 
   No  
 
APPLICATION FEE 
 
I attach payment of the $30 application fee by  
  Cash  (only at Customer service Centre) 
 
(Note: please do NOT send cash by post)  
 
  Cheque 
 
  Money order 
 
If you are given access to the information sought, you may be asked to pay a charge for processing the application ($30 / hour). 
Some applicants may be entitled to a 50% reduction in their processing charges. If you wish to apply for a discount, please 
indicate the reason:  
 
  Financial hardship – please attach supporting documentation (eg a pension or Centrelink card)   AND / OR 
 
  Special benefit to the public – please specify why below:  
 
   
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PRIVACY 
 
In making this application, you are providing personal information such as name and contact details. This 
information will be used for the purpose of assessing your application and ensuring we are able to remain in 
contact with you regarding the status of your application.  Your personal information will be accessed by persons 
who have been authorised to do so, including the decision maker for your application.  Your personal information 
will be handled in accordance with the Privacy and Personal Information Act, 1998. 
 
SIGNATURE 
 
1. 
I declare that the information given on this application form is true and correct. 
2. 
I understand that I must seek  the Copyright Owner’s consent in order to use any part of a copyright 
  
document  for any other purpose. 
 
Applicant’s name 
 
 
           Applicant’s signature 
 
 
         Date 
 
 
 
HOW TO LODGE THIS APPLICATION 
 
  In person: 
Waverley Council Customer Service Centre 
Mail: 
Governance & Integrated Planning 
 
55 
Spring 
Street     Waverley 
Council 
 
 
Bondi 
Junction 
     PO 
Box 

 
8.30am – 5.00pm Monday to Friday 
 
 
Bondi Junction NSW 1355 
 
 
 
OFFICE USE ONLY     
Costcode:  FREDOM 
 
Received by 
 
 
 
 
 
 
 
         Date received 
 
 
 
Information about the GIPA Act is available by calling the Information and Privacy Commission on  
freecall 1800 472 679 or at its website www.ipc.nsw.gov.au