PROOF OF IDENTITY IS REQUIRED	Please use only UPPERCASE letters to complete form
APPLICANT DETAILS
Name: (Mr, Mrs, Miss, Ms)	DOB:	/ /
(Family Name)	(Given Name/s)
Residential Address:	Postcode:
Telephone:	Email:	EXAMPLE@UPPERCASE.COM
COMPLETE THIS SECTION TO HAVE YOUR CORRESPONDENCE FORWARDED TO ANOTHER PERSON
Company and Contact Name:
Company Address:	Postcode:
Telephone:	Email:	EXAMPLE@UPPERCASE.COM
DETAILS OF REQUEST
In accordance with Section 31 of the Freedom of Information Act 1991, I seek amendment of personal records held by the South Australia Police. I claim that the document(s) described below relating to my personal affairs is/are: NOTE: A copy of the document(s) you seek to have amended must be attached to this application. Incomplete Incorrect Out-of-date Misleading If insufficient space, attach separate sheets and indicate the questions to which you are referring. The document(s) containing the information is/are:
Describe exactly what information you want changed:
State the reason(s) why you think this information is incomplete, incorrect, out of date or misleading: Attach any documentation which would support your claim and indicate which documents should be returned to you.
The record(s) should be amended to indicate the following:
IMPORTANT:	No fees or charges apply to the lodgement or processing of this application. A copy of the document(s) to be amended must be attached to this application. SUBMIT THIS FORM AT A POLICE STATION WITH ID AND SIGN FORM IN PRESENCE OF A MEMBER OF SAPOL or EMAIL TO SAPOL.FOI@POLICE.SA.GOV.AU
Applicant Signature:	Documents Attached	Date:	/ /
SAPOL USE ONLY (*Proof of identity of applicant is required and signature must be witnessed by a member of SAPOL)
* Driver’s Licence No.:	* Passport No.:	STATION STAMP HERE
* Birth Certificate: (sighted) * Other: (sighted)
I hereby certify that I witnessed the applicant’s signature, am satisfied as to the correctness of the identity of the applicant, the appropriate payment has been made; and/or valid concession or evidence of hardship is provided.
/ /
(Name)	(Rank / Class.)	(ID No.)	(Signature)	(Date)
IMPORTANT:	SCAN & EMAIL via SAPOL.FOI@POLICE.SA.GOV.AU to Freedom of Information Unit promptly FORWARD ORIGINAL to Freedom of Information Unit (100) by end of shift