Right to Information and Information Privacy Access Application
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www.rti.qld.gov.au
© State of Queensland 2013
SPLES10785 V07 June 2013 / Form 1 RTI-IP
Right to Information and Information Privacy Access Application continued...page 3 of 4
e. Where you think the documents may be located (e.g. facility, business area, unit, person)
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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)
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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).
9. Financial hardship
Concession card holders - Application for financial hardship must be made in writing to the relevant agency. If you hold a valid concession card, and
you are seeking a waiver of processing and access charges, you must show RTI officer your card (or attach a copy of the card to your application).
Note: Not all concession cards are accepted. Please contact the RTI ofcer to be sure your card qualies.
Non-Profit organisations - If you have financial hardship status, you must provide the RTI officer with a copy of the notice from the Office of the
Information Commissioner showing that financial hardship status has been granted.
Note: If you are a non-prot organisation and have sought nancial hardship status under the RTI Act, do not submit this application until you have advice from the Ofce
of the Information Commissioner about whether nancial hardship status has been granted. If nancial hardship status is granted, this status will remain current for
one year from the date of the Information Commissioner’s decision, unless there is a substantial improvement in your organisation’s nancial circumstances.
10. Credit card payments
Not all agencies can accept credit card payments. Please confirm with the agency you’re applying to that it can accept credit card payments before
completing this section of the form (see next page).