A. Particulars of Private Body
B. Particulars of person requesting access to the record   
     a) The particulars of the person who requests access to the record must be given below.   
     b) The address and/or fax number in the Republic to which the information is to be sent must be given.c) Proof of the capacity in which the request            is made, if applicable, must be attached.

Is this request being made on behalf of someone, if yes, select yes below

D. Particulars of record  
      a) Provide full particulars of the record to which access is requested, including the reference number if that is known to you, to enable the record to be located. 
      b) If the provided space is inadequate, please continue on a separate folio and attach it to this form. 
The requester must sign all the additional folios.

E. Fees    
    a) A request for access to a record, other than a record containing personal information about yourself, will be processed only after a request fee has been paid. 
    b) You will be notified of the amount required to be paid as the request fee. 
    c) The fee payable for access to a record depends on the form in which access is required and the reasonable time required to search for and prepare a record. 
    d) If you qualify for exemption of the payment of any fee, please state the reason for exemption

Select Relevant Options below​ for records requested

Copies of requested information will be sent electronically via email (Where possible) 
Do you wish a copy to be posted, if yes postage is payable before records will be sent. 
    - Postage will be sent to the physiacl address listed above

G. Particulars of right to be exercised or protected   
If the provided space is inadequate, please continue on a separate folio and attach it to this form.