This is an HTML version of an attachment to the Freedom of Information request 'AIS scheme auditors'.

Access Application 
Government Information (Public Access) Act 2009
You may use this form to apply for access to government information under the Government Information (Public Access) Act 2009 (GIPA 
Act). If you need help filling out this form, contact the Information Officer on 8202 3768 or email 
Applicant details
Given names:
Company name:
Postal address:
Email address:
Daytime phone number:
I prefer to receive correspondence at the above email address
Identification documents
When seeking access to your own personal information, we will need to establish your identity before providing you with any 
information. If this applies to you, and you are not lodging the form in person at a Motor Registry or with Service NSW where your 
identity will be verified, please attach a certified* copy of one of the following:  
Australian driver licence  
Current Australian passport  
Other photo identification  
If you are completing this form on behalf of someone else, please attach evidence of your authorisation to do so.  
*Certified means that the document has been verified, signed and dated by an authorised person (JP, doctor, teacher, pharmacist, legal practitioner, Postmaster Australia Post).
Transport agency from which you are seeking information
Transport for NSW centrally administers all information requests made to the transport agencies listed below. If you require information 
from a particular agency, please choose from the agencies below. Otherwise please leave blank. The GIPA Act requires payment of a 
$30 application fee. If you tick multiple boxes below you are making separate applications to each agency, which each require 
a $30 fee.

Transport for NSW
Sydney Trains
WestConnex Delivery Authority
Roads and Maritime Services
NSW Trains
State Transit Authority
Terms of your request
Please describe the information you would like to access.
NOTE: Please be as precise as possible. If you do not give enough detail about the information you are looking for we may not be able to find it. You can only apply for access 
to information that is already held by the agency. Attach to this form any additional information that you feel will support your claim for access to the documents/information. 

Transport Shared Services - Access Application - Form no. 5166 (November 2014)
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Processing fee discount
You may be asked to pay a charge for processing the application ($30 / hour). Some applicants may be entitled 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. 
Access to information
How do you wish to access the information? 
Inspect the document/s 
Be provided with a copy of the document/s 
Access in another way (please specify):
If possible, I wish to receive information by email at the above email address 
The Agency may be required to consult with third parties before deciding your application. If the information you are seeking contains 
information about another person, business or government agency, we are required by law to ask whether they have an objection to 
the disclosure of their information. For the purposes of such consultation, please indicate in the boxes below whether you consent to 
the release of the following information to any third parties. 
Your name and/or company name:
Your reason for making this application:
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 
(excluding your personal information) may be recorded in the agency's 'disclosure log'. This is published on the agency's website.
Do you object to this? 
NOTE: You will be contacted and given a further chance to object before the information is placed on the Disclosure Log. 
Application fee
I attach payment of the $30 application fee by: (select one)  
Cheque (enclose a cheque made payable to Transport for NSW)  
Money order (enclose a money order made payable to Transport for NSW)  
There may be additional processing charges in relation to your application – we will notify you if this is required. Please do NOT send 
cash through the post.  
NOTE: This application can be lodged in person at a NSW motor registry or Service NSW Office. Credit card and cash payments can be made at these offices.
Applicant's signature:
Where to send your application
Mail to:  
Information and Privacy Unit 
Transport for NSW  
PO Box K659  
Haymarket  NSW  1240 
Privacy notice
Transport for NSW and the Transport agencies are subject to the Privacy and Personal Information Protection Act 1998 in respect of your personal information. Your personal 
information is being collected to process your application for information under the Government Information (Public Access) Act 2009. The provision of personal information is 
voluntary,  however  if  you  do  not  provide  it  we  may  not  be  able  to  process  your  application.  Transport  for  NSW  and  the  Transport  agencies  may  use  and  disclose  your 
personal  information  for  the  purposes  of  processing  your  application.  Otherwise,  we  will  not  disclose  your  personal  information  without  your  consent  unless  authorised  or 
required by law. Your personal information will be held by Transport for NSW at 18 Lee Street, Chippendale NSW 2008, which is where all applications are initially received. 
If your application is for information held by one of the Transport agencies, it will also be held by the relevant agency at:  
• NSW Trains at 470 Pitt Street, Sydney NSW  
• Sydney Trains at Level 21, 477 Pitt Street, Sydney, NSW  
• Roads and Maritime Services at 101 Miller Street, North Sydney, NSW  
• State Transit Authority at Level 4, 15 Bourke Road, Mascot, NSW 
• WestConnex Delivery Authority at Level 18, 101 Miller Street, North Sydney, NSW  
Generally, you have the right to access and correct the information if you believe that it is incorrect. If you wish to do so please telephone the Transport for NSW Privacy 
Officer on 8202 3768 or email and we will provide you with the details of the relevant agency privacy officer.
Transport Shared Services - Access Application - Form no. 5166 (November 2014)
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