Submission to the Privacy Committee of
                                               South Australia
              Request for Exemption from the Information Privacy
                                                  Principles (IPPs)
             Project / Process:                       (Name the project or process within which the activity is to 
                                                      take place.)
             Activity:                                (Name the activity that requires the collection, use or 
                                                      disclosure of personal information.)
             Agency Making Submission:
             Submission Date:
             Agency Contact:
             Name                      (Name of the person to be contacted about the content of this 
                                       submission.)
             Position Title
             Department                (Include agency and department.)
             Postal Address
             Phone (Work)
             Phone (Mob)
             Email (Work)
             Project Description
             (Give a concise description, in plain English, of the project/process within which the activity is to 
             take place.)
             Other State Government agencies requiring an exemption in
             conjunction with this project or process
             (An exemption will also need to be obtained for any other agency or agencies that require 
             exemption to collect, disclose or use personal information in conjunction with this project or 
             process.  Evidence of agreement between the agency making the submission and the agencies 
             listed below is required.  This could be a letter of request from the Chief Executive to the Privacy 
             Committee seeking an exemption in accordance with this submission.)
             1.   (Agency Name)
             2.   (Agency Name)
             3.   (Agency Name)
             IPP Exemption Template Version 3                                                    Last updated 23/06/2020
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        IPP Exemption Template Version 3                         Page 2 of 12
           Information for agencies to complete this 
           Submission
           Clause 4 of the Proclamation establishing the Privacy Committee of South Australia 
           (Privacy Committee) provides that the Committee may exempt any person or body from 
           one or more of the Information Privacy Principles (IPPs) on such conditions as the 
           Committee sees fit.  
           This document guides South Australian public sector agencies in adequately describing 
           the project and activity for which an exemption is required; presenting a case as to why the
           exemption being sought would be in the public interest; and providing justification for the 
           exemption being granted.  The information provided should inform the Privacy Committee 
           with the information required to determine the weight of the public interest for the activity, 
           against individuals’ right to privacy to enable informed consideration of the request for 
           exemption.
           Notes in red italics are instructions regarding the information to be provided, and can be 
           deleted before submitting the request for exemption to the Privacy Committee.
           This submission must be submitted to the Privacy Committee under a covering letter on 
           agency letterhead signed by the Principal Officer (as defined in the IPPs Instruction).  
           If other agencies require an exemption as a result of the activity, the agency making the 
           submission is required to attach evidence that agreement of the exchange of information 
           for the activity has been reached with the Principal Officer/s of the other agency/s.  If 
           evidence of this agreement is not attached, the Privacy Committee may not be in a 
           position to consider this submission. 
           If the project or activity involves the use of personal information for research and requires 
           the approval of other government committees in accordance with approved guidelines, 
           such as research, ethics or governance committees, these approvals must be obtained 
           prior to submitting a request for exemption from the IPPs.  Copies or details of all such 
           approvals must be provided to the Privacy Committee.  
           Submissions should be addressed to:        Additional contacts:
           Presiding Member                           State Records
           Privacy Committee of South Australia       Level 15, 10 Franklin Street 
           c/- State Records of South Australia       Adelaide SA 5000
           Attorney-General’s Department              Ph: +61 08 8204 8786
           GPO Box 464, Adelaide SA 5001              Email: staterecords@sa.gov.au
           Timeframe for Submissions
           Due to the complexity of some submissions and the involvement of multiple agencies, 
           submissions made less than ten working days prior to a Committee meeting may not be 
           considered at that meeting.  Please contact the Executive Officer on telephone 8204 8786 
           or via email at staterecords@sa.gov.au for further information about meeting dates and 
           submission deadlines.
           IPP Exemption Template Version 3                                            Page 3 of 12
        Definitions
        Activity – refers to the activity that requires the collection, use or disclosure of personal 
        information (eg establishment of a database of clients or a human research project).
        Code of Fair Information Practice - various forms of self-regulation exist, in which agencies
        establish codes of practice and undertake self-regulation, such as the Code which was 
        developed for health and related services.
        Personal information – as defined in the IPPs Instruction (or Code of Fair Information 
        Practice if this Code applies to your agency).
        Principal Officer – as defined in the IPPs Instruction.
        Project / process – refers to the project or process within which the activity is to take place 
        (eg a research project which will utilise a yet-to-be-established database of clients).
        Sample set – a collective term to describe the individuals whose information will be used in
        the activity.
        Source agency – where relevant, another South Australian public sector agency from 
        which you sourced data for use in the activity.  When there is more than one source 
        agency, responses should address each source agency separately.
        The Principles
        The full text of the IPPs Instruction can be found at  https://www.dpc.sa.gov.au/resources-
        and-publications/premier-and-cabinet-circulars
         
        IPP Exemption Template Version 3                        Page 4 of 12