Government Information (Public Access) Act 2009

FORMAL ACCESS TO INFORMATION - APPLICATION FORM

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 Right to Information Officer on 9707 9000 or visit our website at www.cbcity.nsw.gov.au

Important!!

If you require, or wish to view information relating to a property such as plans, reports, consents, construction and occupation certificates or any other DA related material, please review the Informal/Open Access Application Form.

1. Applicant Details

Title *

First Name *

Last Name *

Address *

Phone

Mobile *

Email Address *

2. Proof of Identity

Are you seeking your own personal information

YesNo

Proof of Identity is required: *

Australian Driver's LicenceCurrent Australian PassportOther proof of signature and current address details

Please attach document *

Browse

3. Government Information

Please describe the information you would like to access in enough detail to allow us to identify it. *Note: If you do not provide enough details about the information, the agency may refuse to process your application

ACCESS TO COPYRIGHT PROTECTED DOCUMENTS

In accordance with Section 72(2)( c) of the Government Information (Public Access) Act 2009, Council will not release information (e.g. plans and reports) that is copyright protected unless the copyright owner has expressly consented in writing. View only access of documents may be provided.

4. Form of Access

How do you wish to access the information?

A hard copy of the document(s) An electronic version of the documents

Please note that copying fees and charges may apply

Please specify

5. Disclosure Log

If the information sought is released to you and we consider it may 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 our website. If you object to this, we must first decide if you are entitled to object and if so, whether the objection outweighs the general public interest in including this information in the disclosure log.

You can only object to the inclusion of information on an agency’s disclosure log for one or more of the following grounds:

The information includes personal information about you (or a deceased person for whom you are the personal representative)
The information concerns your business, commercial, professional or financial interests
The information concerns research that has been, or is being, or is intended to be , carried out by or on your behalf
The information concerns the affairs of a government of the Commonwealth or another State (and you are entitled to act on behalf of that government agency).

Please note: if an agency decides to include information in its disclosure log despite your objection, you can seek a review of this decision.

Do you object to this? *

YesNo

6. Application Fee

This application has a cost of $30.00

A payment processing fee of 0.62% applies to all payments made via this service.

Payment *

7. Discount in Processing Charges

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).Special benefit to the public – please specify why below:

Please attach document *

Browse

8. Privacy Notice

In submitting this form, you consent to Council:

1. collecting your personal information as contained in the form; and

2. using the information for the purposes outlined in the form.

Providing your information is voluntary. Should you choose not to provide the information, Council is unable to process your application/request.

You may access any of your personal information that Council holds upon request.

Accept Privacy Policy *

Applicant's Signature *

Draw signature|Type signatureClear

Date *