This is an HTML version of an attachment to the Freedom of Information request 'The report: 'Managing alcohol consumption - a review of licensed social clubs in remote indigenous communities in the Northern Territory''.

Information Act 
Section 18 
Application to access information 

Use this form if you want to apply to access information held by a Northern Territory 
public sector organisation.  Lodge the completed form with the organisation that 
holds the information you want. 

Your name and contact details: 
Title (please circle): Ms / Mrs / Miss / Mr / Dr / 
Postal Address: 
First Name:____________________________________
Family Name:__________________________________ 
Phone:  (B/H)_____________(A/H)_________________ 
Email:________________________________________ Fax:____________________________
Name the Organisation that holds the information you want: 
Describe the information you want: 
Please provide as much detail about the information you want, eg, dates created, location, subject 
matter, who was involved.  (Attach another sheet of paper with more details, if necessary.) 
Preferred form of access: (please tick) 
‰  Copies  
‰  Inspection 
‰  Other (specify, eg, electronic copy) __________________________________________________________

Application fee - $30: (please tick relevant box) 
If your Application is only for records that contain personal information about you, there is no Application fee.  
But if your Application is for information that is not about you, or for a mix of non-personal and personal 
information, you must pay an Application fee.  In some cases, the fee may be waived or reduced. 
‰  I limit my Application to records that contain personal information about me (No Application fee) 
‰  I attach a $30 cheque / money order / receipt* for the Application fee 
‰  I attach a completed Application to Waive/Reduce Fees form in relation to the Application fee. 
*You may pay the fee to any Receiver of Territory Monies and attach the receipt to your Application. 
Processing fee: (please tick if relevant) 
A processing fee may be charged to cover costs of processing the Application.  If your Application is only for 
records that contain personal information about you, the processing fee is more limited.  In some cases, the 
fee may be waived or reduced. 
‰  I understand that I may have to pay a processing fee in relation to the Application. 
‰  I attach a completed Application to Waive/Reduce Fees form in relation to the processing fee. 
Identification: (please tick if relevant)  
The organisation needs proof of your identity.  You may attach a copy of an identification document (eg. 
driver’s licence, passport, etc) if you are posting or faxing this form.  If you are applying in person to the 
organisation, you may produce your identification document to an official, or they may be able to confirm 
your identity in some other way.  If the organisation needs more, it will contact you. 
‰  I attach a copy of an identification document 
Sign Here                                                                                    Date           /            / 
The Information Act requires you to supply your name and an address for correspondence, as well 
as sufficient details to identify the information you want.  Additional contact details will assist the 
organisation to process your Application.  Some personal information may have to be disclosed to 
other people in order to satisfy consultation requirements under the Act and make an informed 
decision on your Application.  If you want to discuss privacy issues, you may contact the 
Information Officer within the organisation. 
More information 
For more information about access to NT government information under the Information Act you 
can visit, or contact the Office of the Information Commissioner — 
phone  1800 005 610 or 8999 1500, fax  8981 3812, email  [email address], or post  PO Box 
3750, Darwin  NT  0801.   
For help filling out this form, contact the Information Officer for the organisation that holds the 
information you want (for details, contact the Government Switchboard on 8999 5511). 

Information Act 
Applying for NT government information (FOI) 
What information can I apply for? 
You can apply to access most government information held by NT public sector organisations. 
That includes information about you.  It includes computer records.  Organisations do not have to 
recreate records that have been destroyed or create new documents from memory. 
Where do I apply? 
Apply to the organisation that you think holds the information you want.  For example, the NT 
Police, the Department of Health and Community Services, the Ombudsman and the Department of 
Justice are public sector organisations.  Before you make an Application, it can help to contact the 
Information Officer in the organisation to talk about the information you want, and the requirements 
of the organisation.  If you do not know who to contact in the organisation, you can try the 
Government Switchboard (8999 5511) or the Office of the Information Commissioner (8999 1500). 
How do I apply? 
You don’t have to use a form but it will usually help with processing if you complete an 
Application form.  Forms are available from the Office of the Information Commissioner and from 
most organisations.  Your Application must: 
•  be in writing; 
•  include your name and address (a telephone contact number will also help); 
•  describe the information you want with enough detail to identify it; and 
•  if you apply for more than just personal information about you, be accompanied by a $30 
Application fee. 
You should include proof of identity with your Application.  The requirements for identification 
may vary between organisations.  The organisation will contact you if more information is needed. 
What do I ask for? 
Government organisations hold a lot of information.  So it may not be very useful if you ask for 
everything you have about my car accident”.  It will be much more helpful if you describe the 
information you want in detail, for example: “I want all police reports and photographs relating to 
a car accident I had on 16 May 2002 at about 8:00pm on the Stuart Highway 30 km north of 
Katherine.  I drove a white Holden ute licence number 123 456, and the other car was a green Ford 
sedan driven by Tom Jones. Sergeant Smith came, took photos and interviewed both of us.
Often, contacting the organisation’s Information Officer before you complete the Application form 
can help you to work out the best way to ask for the information you want. 

What does it cost? 
If you are applying for personal information about you there is no Application fee, but you may be 
charged for costs of providing access to the information, for example, 20 cents per page for standard 
If you want more than just personal information about you, there is a $30 Application fee as well as 
a fee for dealing with the Application (a “processing fee”), eg, for time spent on searching, 
consultation and decision-making.  The organisation may give you a written estimate of the 
processing fee and require you to pay a 50% deposit before it processes your application further.  
You may apply to the organisation to waive or reduce the fees in special circumstances.  
How long will it take? 
The organisation has 30 days from receiving a valid Application to locate the information and 
decide if access will be granted.  More time might be needed, for example, if your Application is 
transferred to another organisation — if it relates to large amounts of information — if extensive 
searches are required — or if consultation with a third party is required.  The organisation will 
inform you if it needs more time. 
What if I am refused access? 
The organisation may decide that you are not entitled to access some or all of the information you 
asked for.  There must be a good reason to refuse you access to information.  For example, the 
information may be exempt under the Information Act because disclosure would be contrary to the 
public interest, or the information may no longer exist.  The organisation must inform you in 
writing of the reasons if it refuses access.  You may ask the organisation to review a decision to 
refuse access (“internal review”).  If you are still not satisfied after that internal review, you may 
complain to the Office of the Information Commissioner. 
Is there another way? 
An application under the Information Act is just one way to access government information.  
Information about the activities of public sector organisations is published electronically and in hard 
copy form.  Reports and statistics are accessible on the websites of organisations and in libraries.  
There are other administrative and legal ways to access government information.  The Information 
Officer in the organisation can discuss what is already available and options for access. 
More Information 
The Office of the Information Commissioner has issued guidelines on many aspects of Freedom of 
Information and Privacy in the Northern Territory.  You may access them on the Internet at or request hardcopies by telephone on 1800 005 610 or (08) 8999 1500.   
Information Officers in each government organisation may be contacted through the NT 
Government Switchboard on 8999 5511.