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 (GIPA Act). If you need help in filling out this form, please
contact the GIPA
Officer on (02) 6773 3096 or visit our website at
http://www.une.edu.au/vc/legaloffice/gipa-act/
1.
Your details
Surname:
................................................................................................
Title: ................
Other names:
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Postal address:
.......................................................................................
Postcode: ...............
Day-time telephone: ..............................................
Facsimile: .......................................................
Email:
..........................................................................................................................
The questions below are optional and the information will only be used for the purposes of
providing better service.
Place of birth:
………………………….......
Main language spoken: ……………………..
Aboriginal or Torres Strait Islander:
Yes / No (circle one)
Do you have special needs for assistance with this application: .......................................................
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
I agree to receive correspondence at the above email address.
2.
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
Current Australian passport
with photograph, signature and current
address
Other proof of signature and current address details
GIPA Application Form 2 Aug 12.docx
1
Government Information (Public Access) Act 2009
ACCESS APPLICATION FORM
3.
Government information
Are you making an
informal access application?
or a
formal access application?
Are you seeking
personal information?
Yes
No
Please describe the
information you would like to access in enough detail to allow us to identify it
(you may attach a separate document describing the information you seek). Note: If you do not give
enough details about the information, the agency may refuse to process your application.
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What
public interest considerations in favour of disclosure of this information do you want to
bring to our attention?
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Are there any
personal factors you wish us to take into account in determining the public interest
considerations in favour of disclosure of this information?
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4.
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) ..........................................................................................
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2
Government Information (Public Access) Act 2009
ACCESS APPLICATION FORM
5.
Application Fee
Please attach payment of the
$30 application fee by cash / cheque / money order (circle one). Note
that an informal access application is FREE. Please do NOT send cash by post
6.
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 the agency’s ‘disclosure log’. This is published
on the agency’s website.
Do you object to this?
Yes
No
7.
Discount in processing charges
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 (e.g. a pension or Centrelink
card).
AND / OR
Special benefit to the public – please specify why below:
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Applicant’s signature: ............................................................................
Date: ......................................................................................................
Please post this form or lodge it with:
Right to Information Officer, Legal Office, University of New
England Armidale NSW 2351
General information about the GIPA Act is available by calling the Office of the Information Commissioner on
freecall 1800 INFOCOM (1800 463 626) or at its website: www.oic.nsw.gov.au
Office use only
Date application received: ................................................................................
File reference: ...................................................................................................
3
fact sheet
Tips to help you access information from
January 2013
NSW government agencies
What rights do I have to access government
How might agencies respond to requests for
information in New South Wales?
information?
In NSW, you have a legal right to access
1. A lot of information will be on their website. If you
government information under the
Government
don’t have the internet you can ask them to
Information (Public Access) Act 2009 – or the GIPA
check and give you a copy.
Act.
2. Much information is easily available. If it is, the
What does the law do?
agency should be able to tell you how and where
you can get the information.
The GIPA Act sets out the rules about how you can
access information from government agencies.
3. If you ask for your own personal information and
it does not involve other people’s information and
This can be information on how a government
is easy to find, the agency should just give it to
agency works or your own personal information.
you.
Who does the law apply to?
4. If you can’t get your information any other way
you might have to make a formal application.
All government agencies in NSW, including:
There is normally a fee for this.
• government departments
• local councils
How do I make a formal application?
• state-owned businesses
You can ask the agency if they have an application
• universities
form, otherwise these are the steps to follow:
• Ministers and their staff.
• put your application in writing
How can I get information?
• say that it is under the GIPA Act
Go to the government agency that is most likely to
• include your postal address
hold the information you need.
• explain the information you want
The easiest ways to do this are to:
• pay the application fee of $30.
1. look on the agency website to see if the
information is available or
What if I can’t pay the fees?
Talk to the agency and ask if they can help you. If
2. contact the agency and ask for the
you are a pensioner or you are struggling financially
information.
the agency may halve the fee.
information and privacy commission new south wales
www.ipc.nsw.gov.au | 1800 IPC NSW (1800 472 679)
Tips to help you access information from NSW government agencies – January 2013
Tips to help you access information from
fact sheet
NSW government agencies
January 2013
How long should my application take?
• 20 working days.
• If the agency needs to talk to another person or
find information stored in archives it might take
an extra 10 to 15 days.
• If it takes longer than this the agency should give
your money back.
What if I don’t get the information I wanted?
You can ask the Information Commissioner to
review the decision by contacting the Information
and Privacy Commission.
How can we help you?
We can help you get government information by:
• telling you what your rights are
• helping you find the right agency
• helping you fill out an application form
• explaining what to expect – how to apply, how
long it should take, how much it should cost
• reviewing the agency’s decision if they don’t give
you the information you asked for in your formal
application.
For more information contact us:
freecall:
1800 472 679
email:
xxxxxxx@xxx.xxx.xxx.xx
website:
www.ipc.nsw.gov.au
information and privacy commission new south wales
www.ipc.nsw.gov.au | 1800 IPC NSW (1800 472 679)
Your review rights – March 2012
Document Outline
