Application For Internal Review by Liverpool City Council

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Application For Internal Review by Liverpool City Council

Application for Internal Review by Liverpool City Council

Please complete this application if you wish to apply for internal review of a decision Liverpool City Council made under the Government Information (Public Access) Act 2009 (‘GIPA Act’).

You must lodge your application with us within 20 working days after notice of decision was given to you.

If you need any more assistance, please contact Council’s Governance team on 1300 36 2170.

General information about accessing government information and rights of review under the GIPA Act is available on the Office of the Information Commissioner’s website: www.ipc.nsw.gov.au.

* All mandatory fields must be completed

Your full name: *

Your postal address: *

Telephone number: *

Email address: *

Details

Please advise the date that you received your notice of decision. *

Please provide the Reference Number *

Please provide your reasons for requesting an internal review: *

Agreement

Agreement *

I agree that the information provided in my Internal Review Application form is true and accurate to the best of my knowledge.

Pursuant to section 85 of the GIPA act, you must pay the mandatory $40 application fee.

Click the bpoint link to pay for your application. Once payment is received an email will be sent to your nominated email with your receipt number

BPOINT PAYMENT

Receipt Number *

Confirmation

Once you have entered your Receipt Number above, click Submit to complete the application.

Privacy Statement
Liverpool City Council is subject to the Privacy and Personal Information Protection Act 1998 (NSW) and the Health Records and
Information Privacy Act 2002 (NSW) which requires compliance with Information and Health Privacy Principles. Your personal
information is being collected to process your Access Application for information pursuant to Part 4, Division 1 of the Government
Information (Public Access) Act 2009. Liverpool City Council may use your personal information for the purposes of processing
your Access Application within the agency. Liverpool City Council is required to collect personal information directly from the
individual unless the individual has authorised collection of the information from someone else. Liverpool City Council will not
disclose your personal information without your consent unless authorised by law. Your personal information will be held by
Liverpool City Council in Electronic Records management System at 33 Moore Street Liverpool. You have the right to access
and correct the information if you believe that it is incorrect.