Request for Access or Correction of Personal Information

Request for Access or Correction of Personal Information

You can use this form to ask us for personal (including any sensitive) information we hold about you or to ask us to correct personal/sensitive information we hold about you.
Title

MrMrsMsOther
Name*

First NameLast Name
Date of Birth (only if you have previously supplied this to us)

DayMonthYear
Date
Current Residential Address (only if you have previously supplied this to us)
Please include street number, street name, suburb, state and post code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Access Request

What information do you need:
I would like to request the following information:
Important: Please be as specific as possible to help us find the right information. You can only request access to personal/sensitive information we hold about you. If another person is involved, each of you must complete and sign separate access request forms.
Fees may apply: In some circumstances, we may charge a fee for giving you access to the personal/sensitive information we hold about you. We will tell you in advance if there is going to be any fee and how much the fee is likely to be, so you can decide if you want to go ahead.

*Fees do not apply to correction requests
Correction Request

You may ask us to correct personal/sensitive information we hold about you, if you consider the information is inaccurate, out-of-date, incomplete, irrelevant or misleading.
I would like the following information corrected:
Important: Be as specific as possible to help us find and correct the right information. You can only request us to correct personal/sensitive information we hold about you. If another person is involved, each of you must complete and sign separate correction request forms.
How would you like this information corrected:
Important: Be as specific as possible to help us find and correct the right information. You can only request us to correct personal/sensitive information we hold about you. If another person is involved, each of you must complete and sign separate correction request forms.
When are you likely to hear from us?

Within a reasonable period of time
Your declaration and authority

By signing and sending in this form, I declare that I am the individual named in the form:
Signature*

Clear
Should be Empty:

Request for Access or Correction of Personal Information

Access Request

Correction Request

When are you likely to hear from us?

Your declaration and authority