CASEY.VIC.GOV.AU 
Freedom of Information  
Request for Access to Documents 
Under the Freedom of Information Act 1982, I wish to gain access to the following document(s):
Forms of Access (Tick one only ) 
I request copies of the document(s) to be forwarded by mail: or 
I request an inspection of the original document(s) or copies of the document(s) if the provision of 
orginals is not feasible.
I enclose an application fee of $27.90 which is payable in respect of this request and I 
understand that I will be supplied with a statement of further charge if appropriate.
Contact Details 
Title:
Full Name:
Company Name:
Address:
Postcode:
Telephone:
Email:
Date: DD
MM
YYYY
Privacy Statement 
Your personal information will be handled in accordance with the Privacy and Data Protection Act 2014 
and used for the specified purpose. You can access your personal information by contacting Council’s 
Privacy Officer on 9705 5200. 

---