Application for Amendment of Personal Information

Application for Amendment of Personal Information

Freedom of Information Act, 1992 (FOI Act) (s.46)

PART 1 – Applicants Details

Surname:

Given Names:

Australian Postal Address:

Suburb: Postcode:

Contact Details: Telephone Number/s: Email:

PART 2 – Details of Application

In accordance with section 46 of the FOI Act, I seek amendment of personal information held by The University of Western Australia (UWA).

I claim that the document/s described below, contain personal information relating to me that is: (Please tick)

inaccurate

incomplete

out of date

misleading

A description of the document/s that contain this information is: …………………………………………………………………………………………………………….……………………………………………………………………………………………………….……..……………………………………………………………………………………………………….….

…………………………………………………………………………………………………………….

Please note that an amendment to personal information relates to information that is contained in specific documents, not information at large.

Area of UWA I believe to be holding the document/s is: (Please tick)

Architecture, Landscape and Visual Arts

Arts, Humanities and Social Sciences

Business School

Education

Engineering, Computing and Mathematics

Law

Life and Physical Sciences

Medicine, Dentistry and Health Services

Natural and Agricultural Sciences

School of Indigenous Studies

Other (Please specify) …………………………………………………………………………

The information I believe is inaccurate, incomplete, and out of date or misleading is:

…………………………………………………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………… ……………………………………………………………………………………………………………

……………………………………………………………………………………………………………

The reason why I hold this belief is:

……………………………………………………………………………………………………………

The details of the amendment I wish to make is: …………………………………………………………………………………………………………….…………………………………………………………………………………………………………….…………………………………………………………………………………………………………….

…………………………………………………………………………………………………………….

Please attach any supporting documentation (copy is sufficient) that would assist in your claim.

(If there is insufficient space on this form, please attach separate sheets.)

PART 2 – Fees and Charges

There is no fee or charges for the lodgement or processing of this application.

PART 3 – Decision

In accordance with section 49(1) of the FOI Act, UWA will advise you of its decision within 30 days of receipt of this application.

APPLICANT’S SIGNATURE ………………………………………………DATE: ……………….

The following is the address where the application is lodged and/or you have any enquiries or require assistance in completing this application:

FOI Coordinator Telephone: (08) 6488 4759
Legal Services Office M461 Fax: (08) 6488 1328
University of Western Australia
35 Stirling Highway
CRAWLEY WA 6009

OFFICE USE ONLY

Received on: ….. / ….. / ……

Proof of Identity (if applicable) Type: …………………………………………………………………

Sighted by: ………………………………………………………………………………………………