FORM 2

REQUEST FOR ACCESS TO RECORD

[Regulation 7]

NOTE:

Proof of identity must be attached by the requester.
If requests made on behalf of another person, proof of such authorisation, must be attached to this form.

TO: The Information Officer

(Address)

E-mail address:

Fax number:

Mark with an "X"

Request is made in my own name Request is made on behalf of another

person.

PERSONAL INFORMATION
Full Names
Identity Number
Capacity in which request is made (when made on behalf of another person)
Postal Address
Street Address
E-mail Address

Contact Numbers	Tel. (B):	Facsimile:
	Cellular:
Full names of person on whose behalf request is made (if applicable):
Identity Number
Postal Address
Street Address
E-mail Address
Contact Numbers	Tel.(B)	Facsimile
	Cellular
PARTICULARS OF RECORD REQUESTED 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. (If the provided space is inadequate, please continue on a separate page and attach it to this form. All additional pages must be signed.)
Description of record or relevant part of the record:




Reference number, if available
Any further particulars of record

TYPE OF RECORD (Mark the applicable box with an "X")
Record is in written or printed form
Record comprises virtual images (this includes photographs, slides, video recordings, computer-generated images, sketches, etc)
Record consists of recorded words or information which can be reproduced in sound
Record is held on a computer or in an electronic, or machine-readable form
FORM OF ACCESS (Mark the applicable box with an "X")
Printed copy of record (including copies of any virtual images, transcriptions and information held on computer or in an electronic or machine-readable form)
Written or printed transcription of virtual images (this includes photographs, slides, video recordings, computer-generated images, sketches, etc.)
Transcription of soundtrack (written or printed document)
Copy of record on flash drive (including virtual images and soundtracks)
Copy of record on compact disc drive(including virtual images and soundtracks)
Copy of record saved on cloud storage server

MANNER OF ACCESS (Mark the applicable box with an "X")
Personal inspection of record at registered address of public/private body (including listening to recorded words, information which can be reproduced in sound, or information held on computer or in an electronic or machine-readable form)
Postal services to postal address
Postal services to street address
Courier service to street address
Facsimile of information in written or printed format (including transcriptions)
E-mail of information (including soundtracks if possible)
Cloud share/file transfer

PARTICULARS OF RIGHT TO BE EXERCISED OR PROTECTED If the provided space is inadequate, please continue on a separate page and attach it to this Form. The requester must sign all the additional pages.
Indicate which right is to be exercised or protected

Explain why the record requested is required for the exercise or protection of the aforementioned right:

FEES
A request fee must be paid before the request will be considered. You will be notified of the amount of the access fee to be paid. 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. If you qualify for exemption of the payment of any fee, please state the reason for exemption
Reason

You will be notified in writing whether your request has been approved or denied and if approved the costs relating to your request, if any. Please indicate your preferred manner of correspondence:

Postal address	Facsimile	Electronic communication (Please specify)

Signed at this day of 20

Signature of Requester / person on whose behalf request is made.

FOR OFFICIAL USE

Reference number:
Request received by: (State Rank, Name and Surname of Information Officer)
Date received:
Access fees:
Deposit (if any):

Signature of Information Officer