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

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 *

Council requires applicants to provide proof of identity (e.g. Driver's licence or passport) only when seeking your own personal information.

PROOF OF IDENTITY

Are you seeking your own personal information?
Please attach a certified copy of identification to application.
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GOVERNMENT INFORMATION

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) *

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. 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

Do you object to information released being included in the Disclosure Log? *
Agreement *

APPLICATION FEE

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

Click the BPOINT link below to pay for your application. Once you have made your payment, please return to this form and insert your receipt number before submitting your formal application.

When payment has been received, an email will be sent to your nominated email with your receipt number

BPOINT PAYMENT