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  • Access Application - Government Information (Public Access) Act 2009

Please complete this application for formal access to Council information under section 41 of the Government Information (Public Access) Act 2009. If you need any more assistance, please contact Council's Governance team on 1300 36 2170 or visit Council's website at www.liverpool.nsw.gov.au

The application fee for a formal application is $30. In some cases, further charges may apply.

* All mandatory fields must be completed.

Applicant Details
I agree to receive all correspondence related to this application at the above email address *

When seeking access to your own personal information, an applicant must provide proof of identity in the form of a certified copy of one of the following documents (i.e. signed and dated) by an authorised witness (Justice of the Peace, Doctor, Pharmacist, Legal Practitioner, Postmaster – Australia Post). For full list see: https://www.ag.gov.au/Publications/Statutory-declarations/Pages/List-of-authorised-witnesses.aspx

Please attach a certified copy of identification to application. *
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If your application is unclear we may not be able to find the documents or it may be deemed invalid (e.g statements such as “including but not limited to…” and “all records held in relation to…” are likely to result in an application being deemed invalid). You can only apply for access to information that is already held by Council. Attach any additional information or documentation that you feel will support your claim for access to the requested documents/information. Attach additional pages if necessary.
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Third Party consultation (if required) *
Do you object to information released being included in the Disclosure Log? *

Please read notes below before sending your application to Council

1. Council will use information provided on this form to process this application. It can also be made available by law to other government agencies. You can find more information about your privacy rights in Council’s Privacy Management Plan on Council’s website or by contacting Council’s Privacy Contact Officer (the Internal Ombudsman) on 1300 36 2170.

2. Copyright applies to most plans and reports. However, section 43(2)(a) of the Copyright Act (Cth) 1968 states that a fair dealing with a literary or artistic work does not infringe copyright in the work if it is for the purpose of giving professional advice by a legal practitioner. Therefore, if you are a legal practitioner and you are seeking a copy of a plan or report subject to copyright, you must state in this application, or an attached letter, that you are a legal practitioner, seeking a copy of the particular plan or report for the purpose of giving professional advice to one of your clients.

3. For more information about public access to information and privacy please contact the Information and Privacy commission on 1800 472 679 or by email: ipcinfo@ipc.nsw.gov.au

Agreement *
APPLICATION FEE

Payment of the $30.00 application fee.

The application fee for a formal application is $30. In some cases, further charges may apply.

Please return to this form and insert receipt number before you submit your formal application.

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