Complaint to the Information Commissioner

Use this form if your complaint concerns the conduct (action or inaction) of an agency in exercising its function under the Government Information (Public Access) Act 2009 (GIPA Act). Please be aware that section 89(4) of the GIPA Act provides that a decision that is reviewable under the GIPA Act cannot be the subject of a complaint to the Information Commissioner. This includes where a person is out of time to apply for a review of the decision.

The Information and Privacy Commission (IPC) deals with complaints by taking measures to assist resolution and can deal with a complaint by investigation.

We will need to contact you about the complaint, so please provide your name and contact details including one contact number if possible. If you do not provide this information we may not be able to deal with the complaint or make necessary enquiries We will use the information you provide to deal with your complaint. We will usually provide a copy of the complaint along with any additional information you have provided, (excluding your contact details) to the agency you are complaining about, and if necessary, others who have relevant information about the complaint. By completing and submitting this form you consent to the IPC using your information for these purposes. If you have any questions about this or need held to complete this form, please contact our enquiry line on 1800 472 679.

Your personal information will be used and stored in accordance with the Privacy and Personal Information Protection Act 1998 (NSW).

Section 1: Details

Name of the agency you are making a complaint about:

Your full name:

Your postal address:

Telephone number:

Email address:

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

Yes

The Information and Privacy Commission (IPC) assesses each complaint received. While you may elect not to disclose your name to the Agency concerned, without these details, we will be unable to effectively assess, make enquiries or investigate your complaint.

Please also be aware that the identity of the complainant may become apparent in the course of those enquiries.

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:

Large font

National Relay Service

Translating & Interpreting Service

Other

If the complaint is on behalf of someone else, please provide their name and contact details:

What is your relationship to this person? (e.g. parent/friend/lawyer):

Does this person know you have submitted this application on their behalf?

Yes

Unsure

Please upload a signed authority to act on their behalf:

One file only.
2 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx.

Section 2:

Please describe your complaint. It is useful to include what happened, when it happened and who was involved.

What would you like to see the agency do to resolve your complaint?

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. By submitting this form, you are consenting that the IPC will:

use this form to process your complaint
give the details of your application, a copy of this form and your related information to the agency named above. This will include any additional information you may provide, including attachments to this form.

In any complaint process, all parties are given the opportunity to provide information. If you do not consent, the IPC’s consideration of the issues and further action may be limited.

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.

Please write your name:

Date: DD/MM/YY

If you have any concerns about release of your name and/or complaint, please tell us the reason here.

Section 4: Footnotes

1. 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

We prefer to receive electronic copies of all documents if possible. However, you can also print and send this form and any attachments to us.

Please send your completed form via one of the following methods:

By email: ipcinfo@ipc.nsw.gov.au
By fax: (02) 6446 9518
By mail: GPO Box 7011, Sydney, NSW 2001
In person: Level 15, McKell Building, 2-24 Rawson Place, Haymarket NSW 2000
Electronically: by selecting SUBMIT

Please keep a copy for your records.
For more information about the GIPA Act visit our website: www.ipc.nsw.gov.au

Upload Supporting Documents

Maximum 3 files.
2 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Complaint to the Information Commissioner

Navigate

Useful links

IPC Social Media