GIPA Act – NSW Fair Trading Information Access Form

Your details
Application confirmation and payment receipts will be sent to this email address.
I agree to receive correspondence at the above email address *

Proof of identity

If you are seeking access to any personal information (including your own), you will need to provide proof of identity. Please provide a copy of one of the following:

Identity type

Maximum file size 2MB, only jpg, pdf, doc, docx file types allowed.

I am applying on behalf of: *

Please attach authorisation from the other party, allowing NSW Fair Trading to release their personal and/or health and/or business information to you, as their nominated representative.

Maximum file size 2MB, only jpg, pdf, doc, docx file types allowed.

Information requested

Consultation with third parties

We may need to consult with third parties before deciding on your application. Please indicate in the boxes below whether you consent to the release of the following information to any third parties. This information will assist any third parties to understand why you are seeking the information.

Do you consent to the release of your identity to any third parties during the consultation process? *
Do you consent to the release of your client's identity to any third parties during the consultation process (if applicable)? *

Disclosure log

If the information you have requested is released to you and would be of interest to other members of the public, details about your application may be recorded in the agency's disclosure log. This is published on the agency's website. No personal information will be published on the disclosure log.

Do you consent to this? *

Processing charges

You may be asked to pay processing charges of $30.00 an hour for the time required to complete your application. If required, you will be advised in writing. Some applicants may be entitled to a 50% reduction of processing charges on the grounds of personal financial hardship, or if the information sought is of special interest to the general public. Note: The discount does not apply to the $30.00 application fee that is required to be provided upon completion of this form.

Do you wish to apply for discounted processing charges if further charges are applicable to the processing of your application? *
Maximum file size 2MB, only jpg, pdf, doc, docx file types allowed.

Privacy statement

The Department of Customer Service respects your privacy and is committed to protecting your personal information. We operate in accordance with the provisions of the Privacy and Personal Information Protection Act 1998. The purpose of collecting the information requested within this form, is to allow our agency to process your access application under the Government Information (Public Access) Act 2009. The information will be reviewed and held by the Right to Information Team, and will not be shared with any third parties without your consent. All information provided will be treated confidential. Please see our Privacy Management Plan for further details.

If you require assistance lodging this application you may call the GIPA team on 13 10 50 or send an email to

Application fee

An application fee of $30.00 applies to all access applications. Processing cannot proceed until this fee is paid.