RM 27 APPLICATION FOR THE SUPPLY OF ENROLMENT

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2013 EDUCATION AND OUTREACH GRANTS APPLICATION FORM

CONFIDENTIAL ELECTOR INFORMATION

RM 27

APPLICATION FOR THE SUPPLY OF

ENROLMENT INFORMATION

To be completed by persons, organisations and government departments requesting access to enrolment information under ss.25B or 25C of the Electoral Act 1907

INSTRUCTION PAGE

Enrolment information is protected by the Electoral Act 1907 (s25E) which provides significant penalties for its misuse, unauthorised disclosure or commercial use.

The electoral roll is made available for anyone to view at the office of the Western Australian Electoral Commission (s25(1)). Access to enrolment information in printed or electronic form is restricted to those cases where the Electoral Commissioner considers that the public interest in making the enrolment information available outweighs the public interest in protecting the privacy of personal information. Applicants for enrolment information must complete the application form RM 27 which also contains a confidentiality agreement. Details of your application, if approved, will be recorded in a register that may be made available for public inspection and may be reported in the Annual Report.

A fee is charged for roll products produced by the Commission. Usually invoices are despatched with the roll product. You will be notified if payment in advance is required once your application has been approved. Recipients of regular monthly, quarterly or six monthly updates will be offered a 10% discount if they agree to be invoiced annually. Annual invoices would cover the financial year (1 July to 30 June) and would be issued in December, such that half is sought in arrears and half in advance.

The following roll products are available:

Standard Products: These products are generally available within 2-3 days of approval. Please contact the Commission for current pricing prior to lodging your application.

A-Z external roll. A list of every elector in the State arranged in A-Z order of name as a PDF file. This is produced at the end of each quarter and is posted to customers with an invoice. Customers can arrange for on-going supply on a quarterly, six monthly or annual basis.

A-Z internal roll. A list of every elector in the State arranged in A-Z order of name as a PDF file. This is produced at the end of each quarter and is posted to customers with an invoice. Customers can arrange for on-going supply on a quarterly, six monthly or annual basis. This product includes elector date of birth, which is not public information, and therefore applicants for this product need to establish a critical need, of significant public benefit or for law enforcement or for serious public health issues, which can’t be met by other means. For example, if it is possible for the applicant to write to the elector and request the elector to provide date of birth, applicants should request the A-Z External Roll rather than the A-Z Internal Roll.

State District candidate roll. This is only available to persons who have nominated as a candidate for a State electoral District or Region. These are provided free of charge.

Local Government residents roll. Generally this is only available to local government CEO’s. Local governments will only be provided with elector information for their local government area. They will not be given local government rolls for other councils. These are usually provided free of charge.

Customised Roll Products:

Roll extracts. These are customised to individual requirements and can include random or complete selections based on age, gender, location, etc. Data can be output in a format suitable for a mail merge. Extracts can be set up to be a once off job or to be run each month or quarter. Extracts tend to cost significantly more than standard roll products as the fee charged includes programming and testing costs. These products should be requested 6-8 weeks ahead of the required date as turnaround time is dependent on the availability of programming staff.

Extracts for medical research. Do not use this form contact the Health Department Data Linkage Branch 9222 4261

Before going forward with an application please consider the following guidelines:

Applicants must be able to demonstrate that their proposed use of the information has a strong community benefit or is required for law enforcement or for serious public health issues.

As a general rule the applicant for confidential elector information needs to prove a critical business need for the information that cannot be met by other means.

Generally the only information about an elector that will be made available is Surname, Given Names, Residential Address, Occupation and Gender.

Generally successful applicants will be either, a State government agency, a University, a recognised medical research organisation, a local government, or a candidate for State or local government elections conducted by the Commission.

Applications will not be approved for commercial purposes (e.g. money making ventures, debt collection, legal process, credit checking). This is specifically prohibited by the Act (s 25(3)).

Applications to use elector data in public libraries will not be approved.

Commonwealth agencies will not be provided with elector information unless the information is not held by the Australian Electoral Commission (AEC). Commonwealth agencies should contact the AEC.

Applications from organisations are to be signed by the Chief Executive Officer of the Organisation who assumes corporate responsibility for the agreement and ensuring that anyone given access to the elector data as part of an approved project are informed about the confidentiality agreement conditions. Applications from individual employees or contractors of an organisation will not be accepted.

Where the request is already authorised by legislation or is in support of a function authorised by legislation, please include in the purpose details of the relevant Act and sections of that Act with the application.

What happens to my application?

If your application is approved and you have requested a standard product, the product will be prepared and despatched by electronic transfer.

If your application is approved and you have requested a customised roll product, a quotation will be prepared and sent to you for acceptance prior to work commencing.

You will be advised of the outcome of your application.

APPLICATION FOR THE SUPPLY OF

ENROLMENT INFORMATION

ss.25B or 25C of the Electoral Act 1907

Please read the instruction page before completing this application

Name of applicant	(name of CEO)
	(organisation/ department)
	(address)
	(postal address – if different to address)
Contact person	(name)
	(title/ position)
	(branch/section)
	(phone number)	(email address)

Roll product requested	Tick one of the boxes below	Additional Information
A-Z external roll		Frequency of ongoing supply (tick one box)	quarterly	6 monthly	annually
A-Z internal roll		Frequency of ongoing supply (tick one box)	quarterly	6 monthly	annually
State District candidate roll		(specify district/region required here)
Local Government residents roll		(specify local government/ward required here)
Roll extracts		Please provide detailed specification on a separate sheet

Proposed use of roll product (if insufficient space attach detailed explanation on a separate sheet)


Delivery information Data files are delivered via secure electronic transfer. Details will be provided on approval of this application.

Have you requested regular updates and wish to be invoiced annually to receive a 10% discount? (tick one of the boxes)		Yes	No
Invoicing Instructions (Provide details for invoicing)	(agency invoicing address)
	(branch name - if applicable)
	(contact name)	(phone number)
	(purchase order – if required by your agency)	(email address)

Confidentiality Agreement
Name of applicant	(name of CEO)
	(organisation/ department)
I understand and agree that enrolment information is made available by the Electoral Commissioner on the basis that the information will: be used only for the purpose or purposes identified in this application not be copied (except for backup) or given to any other person or organisation (except where that is identified in the purpose) be securely destroyed once the proposed use for the data has been completed and Form RM 27X - Certificate of Destruction will be completed and returned to the Commission be available only to officers on a ‘need to know’ basis not be used for a commercial prupose. I understand that the Electoral Act 1907 provides penalties for misuse, unauthorised disclosure or commercial use of enrolment information (ss25D and 25E). I also understand that I will become a ‘custodian’ of data for the purposes of the Privacy Act 1988 and Privacy Principles (www.privacy.gov.au) The conditions of this agreement are to be drawn to the attention of the officers who will be accessing the data. I also understand that a breach of the above conditions may lead to a review of arrangements. / / Signature of Applicant/ Chief Executive Officer Date

This section for Western Australian Electoral Commission OFFICE USE ONLY
Approval Details		Dispatch Details
A pproved	R ejected	S ecure Electronic File Transfer
		R M 27X – Certificate of Destruction sent
Date		Date
Signed		Signed
		R M 27X – Certificate of Destruction returned

Please return this form to:

Enrolment Group

Western Australian Electoral Commission

Level 2, 111 St Georges Terrace

PERTH WA 6000

GPO Box F316 PERTH WA 6841

Telephone: (08) 9214 0400

Facsimile: (08) 9226 0577

Email: [email protected]

Feedback: www.waec.wa.gov.au

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