Application for Assessed Disclosure

Right to Information Act 2009 - Application for Assessed Disclosure

Would you prefer to print this form and complete it it manually?

Application for Assessed Disclosure download and send to rti@stategrowth.tas.gov.au or GPO Box 536, HOBART TAS 7001

Personal Information Collection Statement

You are providing personal information to the Department of State Growth, which will manage that information in accordance with the Personal Information Protection Act 2004. The Right to Information Regulations 2021 specifies the information that must be provided when making an application under the Right to Information Act 2009. Your information will be used by the Department for the purposes of managing your RTI request. Failure to provide this information may make your application invalid and unable to be processed. The Department may also use the information for related purposes or disclose it to third parties in circumstances allowed for by law. You have the right to access your personal information by request to the Department.

Online form below

Applicant details

First Name *

Surname *

Email address *

Phone number *

Postal address *

Address *

City *

State *

Postcode *

Public Authority or Minister applied to *

General topic of information applied for (in a few words) *

Description of efforts already made to obtain this information prior to this application *

Application fee - $47.75 *

IncludedRequest to waive fee

Payment methods

Cheque or Money Order to Department of State Growth
Direct deposit to WESTPAC BSB 037-001, Account 259881
Credit card – by calling Finance Branch 1800 030 688

The current application fee is $47.75

Request to waive fee *

Member of ParliamentJournalistFinancial HardshipGeneral public interest or benefit

Public interest *

Financial hardship *

e.g. Centrelink or Veterans Affairs Card *

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Details of information sought *NB: All third-party personal information discovered in a search will be treated as out-of-scope, unless it relates to Tasmanian Government statutory officers, decision-makers, Senior Executive Service officers, or senior Ministerial staff.

Include any relevant dates and time periods that may relate to the information being sought:

If you have additional supporting information please upload it here

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