GIPA Internal Review application

Government Information Public Access Act 2009
Internal review application
  
Please note: questions marked with an * are required and must be completed before submitting this application.

This form should be used if you wish to apply for an internal review of a decision made under the Government Information (Public Access) Act 2009 (GIPA Act).

You must lodge this form within 20 working days after notice of the decision was given to you. If more than one person is entitled to a review, the review period will commence at the expiration of the 20 days.

If you need help in filling out this form, please contact Council’s Governance Coordinator Phone (02) 6499 2222.

General information about accessing government information under the GIPA Act is available on the Information and Privacy Commission NSW (IPC’s) website:  www.ipc.nsw.gov.au


Your details
Surname
This question is required
First name
This question is required
Postal address
Street*
City/Suburb
State*
Zip/Post Code*
Country*
This question is required
Phone
This question is required
Email
Please include in your internal review application the following information about the Notice of Decision
Date of decision: 
File or CRM reference: 
Please attach any supporting documentation.
Maximum of five documents can be uploaded.
Choose a file
Maximum of five documents can be uploaded.

Form of Access
  
In the interests of the environment and where possible, this information will be provided electronically, therefore please ensure you have provided an email address. An alternative method of provision my be considered.

A copy of the documents will be provided to you electronically to the email address provided on this application.

If you wish to be provided access in another way please specify how you would like to access the information.

Fees and Charges
Once you have submitted this form you will need to pay your application fee of $40. Your application will not be processed until payment has been received.

You can pay the application fee (note, your application will not be processed until payment is made):
by calling Council's customer service staff on 02 6499 2222 once you have submitted this form and pay with a credit or debit card
by cheque, posted to Bega Valley Shire Council, PO Box 492, Bega NSW Bega
by visiting the Bega Office, Zingel Place, Bega

Decision details

If you would you like the entire decision reviewed please advise What is the decision to be reviewed (s80 of the GIPA Act)?
(a) A decision that your application is not a valid access application
(b) A decision to transfer an access application to another agency, as an agency-initiated transfer
(c) A decision to refuse to deal with an access application (including a decision that is deemed to have been made ie. if your application was not decided on time)
(d) A decision to provide access or to refuse to provide access to information
(e) A decision that government information is not held by an agency
(f) A decision that information applied for is already available to you
(g) A decision to refuse to confirm or deny that information is held by an agency
(h) A decision to defer the provision of access to information
(i) A decision to provide access to information in a particular way (or a decision not to provide access in the way requested by you)
(j) A decision to impose a processing charge or to require an advance deposit
(k) A decision to refuse a reduction in a processing charge
(l) A decision to refuse to deal further with your access application because you failed to pay an advance deposit within the time required for payment
(m) A decision to include information in a disclosure log despite your objections (or a decision that you were not entitled to object).
OR
If you would like a particular aspect of the decision reviewed under (s82(3)) of the GIPA Act the internal review can be limited to a particular aspect of a reviewable decision (such as by being limited to particular information to which the decision relates)
Please specify what you would like reviewed.
Submit