Right to Information and Information Privacy Access Application
3/5
www.rti.qld.gov.au
© State of Queensland 2016
SPLES17813 V09 29 January 2020 / Form 1 RTI-IP
Right to Information and Information Privacy Access Application continued...page 3 of 5
b. The type of documents (e.g. internal memos, emails)
......................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................
c. The time period / date range you would like us to search within (e.g. September 2011 - June 2012)
......................................................................................................................................................................................................................................
d. Relevant document reference numbers (if known)
......................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................
e. Where you think the documents may be located (e.g. facility, business area, unit, person)
......................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................
f. Any other details you believe will assist us in dealing with your application Note: Include additional information that the agency requires in the
space provided or as an attachment to your application (e.g. date of birth will assist in locating relevant les to distinguish you from someone with
the same name)
......................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................
7. Preferred access type (tick one):
Note: Your preferred access type may not be available. If you choose to access documents by email, CD, DVD or inspection, there will be no charge for this
access.
Inspect document/s Photocopy of document/s (charges may apply) Document/s sent to me by email
Copy of the document/s on DVD Copy of the document/s on CD
Note: Information that is released following an application under the RTI Act, and is not the applicant’s personal information, may be published in an
online disclosure log. See privacy notice.
8. Evidence of identity
If you are seeking access to documents that contain personal information either in relation to you or on behalf of another person, you must provide
evidence of your identity with this application or within 10 business days of making this application in order for your application to be processed.
If you are seeking documents on someone’s behalf, both parties must provide evidence of their identities. (If you are not seeking any personal
information, you are not required to provide evidence of your identity.)
Applying:
by post — attach a certified copy of your identification document to this application form.
in person — produce the original identification document for the RTI officer to sight.
by email or fax — post or present a certified copy of the identification document to the relevant agency to which you are applying for information.
(A certied copy is considered valid if it is witnessed by a lawyer or notary public, a commissioner for declarations or a justice of the peace or in the
case of a prisoner, a corrective services ofcer. ‘refer note below’)
Note: Documents that provide sufcient evidence of identity include:
• Current driver’s licence
• Identifying page of current passport
• Birth certificate
• Copy of a prisoner’s identity card certified by a corrective services officer
• Statutory declaration of an individual who has known the applicant for at least one year
(A declaration template can be downloaded at www.court.qld.gov.au/forms).