Department of
Racing, Gaming and Liquor Government of
Western Australia
APPLICATION FOR ACCESS TO DOCUMENTS
(under
Freedom of Information Act 1992, S.12)
DETAILS OF APPLICANT
Surname: ______________________________________________________________________
Given Names: __________________________________________________________________
Australian Postal Address: _________________________________________________________
Postcode: _______________Telephone Numbers: _____________________________________
If application or on behalf
of an organisation
Name of Organisation/Business: ____________________________
DETAILS OF REQUEST
Personal Information
Non-personal Information (
please tick)
I am applying for access to document(s) concerning
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
FORM OF ACCESS
I wish to inspect the document(s):
Yes
No
I require a copy of the document(s):
Yes
No
I require access in another form:
Yes
No
(specify)
FEES AND CHARGES
Attached is a cheque/cash to the amount of $................... to cover the application fee. I understand
that before I obtain access to documents I may be required to pay processing charges in respect of
this application and that I will be supplied with a statement of charges if appropriate.
Are fees and/or charges applicable for this request?
Yes
No
(See over for charges summary)
Applicants signature: _____________________________________ Date: ........./........./.........
______________________________________________________________________________
(Office use only)
FOI Reference Number: .................................................
Received on ............../.............../...............
Acknowledgment sent on: ................/................../.............
Proof of Identity (If applicable)
Type: .............................................................. Sighted: .....................................................................
NOTES FOR FOI APPLICATIONS
Please provide sufficient information to enable the correct document(s) to be identified.
The Department of Racing, Gaming & Liquor may request proof of your identity.
If you are seeking access to a document(s) on behalf of another person, the Department of Racing,
Gaming & Liquor will require written authorisation.
Your application will be dealt with as soon as practicable (and, in any case, within 45 days) after it
is received.
Further information can be obtained from the FOI Coordinator, Department of Racing, Gaming &
Liquor, by telephoning (08) 6551 4888. Copies of the
Freedom of Information Act 1992 are on line
at
www.slp.wa.gov.au.
Forms of Access
You can request access to documents by way of inspection, a copy of a document, a copy of an
audio or video tape, a computer disk, a transcript of a recorded document or of words recorded in
shorthand or encoded form, or a written document in the case of a document from which words
can be reproduced in written form.
Where the Department of Racing, Gaming & Liquor, is unable to grant access in the form
requested, access may be given in a different form.
Fees and Charges $
1.
Type of Fee
Application fee under section 12 (1)(e) of the Act $30.00
2.
Type of Charge
(a)
A Charge for time taken by staff dealing with the application (per hour, or
pro rata
for part of an hour): $30.00
(b)
Charge for access time supervised by staff (per hour, or
pro rata for part of an hour)
plus the actual additional cost to the agency of any special arrangements (eg: hire
of facilities or equipment): $30.00
(c)
Charges for photocopying
(i)
per hour or pro rata for part of an hour of staff time: $30.00
(ii)
per copy: $0.20
(d)
Charge for time taken by staff transcribing information from a tape or other device
(per hour or
pro rata for part of an hour): $30.00
(e)
Charge for duplicating a tape, film or computer information Actual Cost
(f)
Charge for delivery, packaging and postage Actual Cost
3.
Advanced Deposits
(a)
An Advance deposit which may be required by an agency under section 18 (1) of
the Act, expressed as a percentage of the estimated charges which will be payable
in excess of the application fee: 25%
(b)
Further advance deposit which may be required by an agency under section 18 (4)
of the Act, expressed as a percentage of the estimated charges which will be
payable in excess of the application fee: 75%
Applications may be lodged
By post, addressed to:
Department of Racing, Gaming & Liquor
PO Box 6119
East Perth WA 6892
In person at:
Department of Racing, Gaming & Liquor
Gordon Stephenson House
Level 2, 140 William Street
Perth WA 6000
Document Outline