Please complete this form to make a formal access application for government information held by
Department of Planning, Industry & Environment
under the Government Information (Public Access) Act 2009 (GIPA Act). If you need help filling out this form, please contact the GIPA team on (02) 9860 1440 or at firstname.lastname@example.org.
You can also visit our website.
Are you seeking personal information?*
Information to cover the period:*
This is required only if you are requesting your own personal information or the personal information of the person you are representing.
When seeking access to personal information, you must provide proof of identity in the form of a certified copy of any one of the following documents:
If you object to this, you will be asked to supply reasons before your application is finalised:
6. Discount in processing charges
You may be asked to pay a charge for processing the application ($30 per hour after the first hour). Some applicants may be entitled to a 50% reduction in of the processing charges. If a discount is given, the $30 application fee will pay for the first two hours of processing, not just the first hour. If you are applying for your personal information, the first 20 hours of processing will be free of charge.
7. Application fee and lodgement
If you need help filling out this form, please contact the GIPA team on (02) 9860 1440.
We will contact you within five working days of receiving your application and continue to keep you informed as your application is processed. We will try to deal with your request as soon as possible and within 20 working days of receiving your application. If we need to consult a third party or we need to retrieve archived records, the 20-day period will be extended by 5-10 days.
The application fee of $30 is required to make your application valid, unless the payment of the fee has been reduced or waived. In addition to the application fee, we may charge $30 per hour after the first hour to process your application (unless you have asked for your personal information, in which case the first 20 processing hours are free). Processing includes searching for the information, consulting third parties and making a decision about access.
You may be given a 50% reduction in the fees and charges, if you can show you would suffer financial hardship, are a full-time student or a not-for profit organisation, or you can show that the information is of special benefit to the public generally. We can also waive, reduce or refund the fees and charges, depending on the reasons you put forward.
Before you submit - please note if your payment is unsuccessful all information entered on this form will be lost. You will not be able to go back! You may want to print or save a copy before submitting.
The information provided on this application form is being obtained for the purpose of processing your GIPA application. Providing this information is required by law. It will be stored securely. If you do not provide all or any of this information it could prevent or delay the processing of your application.
Are you sure you want to delete this file?
Please select one of proof of identity before file upload
Please select file before clicking on upload button
Please select Financial Hardship option before file upload
Please select Not-for-profit organisation option before file upload
Please select Full-time student option before file upload
Please select Special benefit to the public option before file upload