Complaint to the Information Commissioner

Section 1: Details
I want my name to be kept confidential and not provided to the agency:

If you are deaf or you have a hearing or speech impairment, you can call us through the National Relay Service on 133 677, or if you would like the assistance of an interpreter, call us through the Translating and Interpreting Service on 131 450.

Do you require special assistance when communicating with us? If so, please select:
Does this person know you have submitted this application on their behalf?
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Section 2:
Section 3:

It will assist the Information Commissioner to have your consent for the complaint form to be provided to the agency so that the Commissioner can collect all of the information required to assess your complaint.

Please confirm:

From June 2017, the IPC will be conducting a client satisfaction survey to find out how we can further improve our services. We may also report on the results of this survey.

After your complaint has concluded, you may be randomly selected to be part of this voluntary survey. The survey will be sent to participants via an email from the IPC. Your personal details, and contact information provided in this form will be used to contact you for the IPC client satisfaction survey. Should you choose to complete the survey, we assure you that all comments you make will be completely confidential.

Should you prefer NOT to take part in the survey, you may be assured that your decision will in no way affect the services you receive from the IPC. You can choose to opt-out of participating in the survey by advising us via return email.

Section 4: Footnotes

It is not a requirement under the GIPA Act or the Government Information (Information Commissioner) Act 2009 (GIIC Act) that you complete an application form when making a complaint. This form is designed to assist you in providing the key information we might need to resolve your complaint.
2. The GIPA Act regulates NSW state government departments and agencies, Ministers and their staff, state owned corporations, universities and NSW local councils. Each of these are defined in the GIPA Act as an 'agency.'
3. “Conduct” can include an action, a decision, or even inaction by the agency. For example the 'conduct' in your case might be a decision to refuse you access to information that you formally applied for, or the action of removing open access information from its website, or the inaction of a failure to respond to an informal request for information.

Section 5: Other information

You can print and send this form and any attachments to us:
By email:
By fax: (02) 8114 3756
By mail: GPO Box 7011, Sydney, NSW 2001
In person: Level 17, 201 Elizabeth Street, Sydney NSW 2000
Electronically: by selecting SUBMIT
Please keep a copy for your records.
For more information about the GIPA Act visit our website:

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