GIPA - Formal Access Application

This is a Formal Access Application for government records held by Queanbeyan-Palerang Regional Council under the Government Information Public Access Act 2009 (GIPA Act).

Applications under the GIPA Act carry a $30 application fee. Further charges may apply for processing based on the staff time required to process your application.

Applications under the GIPA Act must be decided within 20 working days of receipt unless a valid extension is applied. The list of permissible reasons for an extension are outlined under section 57 of the GIPA Act.

QPRC does not provide records of an individual’s personal information. However, you have a right to access records of your own information held by Council. If you are seeking to access your own personal information, please include proof of identity with your submission. ID must be issued by a recognisable authority, such as a drivers licence or a passport.

An authorised officer of QPRC will assess this GIPA application for records and apply a public interest test. You have a right to have any subsequent notice of decision reviewed.

Your details

Company Name (if applicable)

Full name *

Email *

Phone *

Postal address *

I agree to receive all correspondence relating to this application via email? *

YesNo

Part 2 - Information applied for

Please provide details of the QPRC records you are seeking to access in the field below, including as many specific details as possible. *

*Applications that are too general, too broad in scope, or may otherwise require a substantial and unreasonable diversion of Council resources may be re-negotiated or refused under the GIPA Act.

Part 3 - Disclosure considerations

Why have you requested the above records from QPRC?*

*An explanation for your request is not required under the GIPA Act. However, additional details will assist staff in assessing public-interest considerations for disclosure.

Have you requested copies of your own personal information?

YesNo

If yes, please provide copies of your identification

Browse

Part 4 - Fees and Charges

Applications under the GIPA Act carry a $30 application fee. Additional processing charges may be applied based on the number of staff-hours needed to process your application. Council staff may contact you to request an advance deposit of up to 50% of estimated processing charges.

There are no charges for the first 20 hours of processing of an application for personal information.

If you are applying for a waiver or reduction in processing fees, please select why you are seeking a reduction

Waiver of charge for charge for personal information (20 hours)Financial hardship (50%)Special public benefit (under section 66 of the GIPA Act)Other public interest ground to be considered

Other public interest grounds to be considered - please specify

Part 5 - Disclosure Log

If the information released in response to your application would be of interest to other members of the public, details of your application may be recorded on Council’s disclosure log. The log is published on the QPRC website. Do you object to this?

YesNo

Part 6 - Public Interest Test

A public interest test will be applied to the information sought through this Formal Access application. Considerations for and against disclosure which may be given weight are listed in the tables under section 12 and section 14 of the GIPA Act.

If you wish to make a submission as to what public interest considerations you think should be taken into account when determining your application, attach your submission to this form.

Applicant Signature *

Draw signature|Type signatureClear

Date *