Application to close records under Section 28 of the Territory Records Act 2002

I wish to apply for a Territory Records Act 2002 Section 28 declaration to prevent public access to the following records. In applying for this declaration I acknowledge the records could still be accessible through certain exempt provisions of the Freedom of Information Act 1989.  Until the commencement of Part 3 of the Territory Records Act 2002 this application is made under Section 81 of the Legislation Act 2001.	
Applicant Agency Details	
Agency:		
Business Unit:		
Authorised Officer Name & Phone:		Authorised Officer Signature		
	
Record Details for publication on the Register	
Record No.:		Folio No.:		Date Created:		
Title:		
Records Disposal Schedule Name & Class No.:		
		
Function/Activity:		
	
Exemption Category	
Under which category is the Section 28 Declaration being sought?	
	Affecting relations with Commonwealth and the States; section 34 (1) FOI Act	
	Affecting enforcement of the law and protection of public safety; section 37 FOI Act	
	Affecting personal privacy; section 41 FOI Act (see over for more information)	
	Subject to legal professional privilege; section 42 FOI Act 	
	Disclosure of which would be in contempt of the Legislative Assembly or a court; section 46 FOI Act	
	
Justification	
The exemption category has been selected from the applicable categories listed above and to assist in clarifying the justification a standard exemption can be chosen from the list of functions below.	
	Compensation – Case Management 002.016.001	
	Financial Management – Salaries 005.096.001	
	Personnel – Employment Conditions 012.039.001-012.039.013	
	Personnel – Salaries 012.096.001	
Provide as much information as possible to enable an assessment of how the exemption category relates to the records for which an exemption is being sought. The Director may inspect the records for which this application is being made. Please note the wording of section 41of the FOI Act  relating to Documents affecting personal privacy (1) A document is an exempt document if its disclosure under this Act would involve the unreasonable disclosure of personal information about any person (including a deceased person).	
	
Territory Records Office Use Only	
Determination by the Director of Territory Records	
	Exemption Granted under Section 28 of the Territory Records Act 2002	
Exemption Number			
	
	Exemption not granted. See explanatory notes below.	
Explanatory notes for Exemption not granted	

	Notified Business Unit Contact Office of application outcome	
Director’s Signature:		Date:		
	
Agency Record Exemption Registration	
	Details exempt record entered into Agency Section 28 Declarations Register	
	
Officer name:			
Position:			
Signature:		Date: