Agency Loan of Official Records - Request Form

Agency details

Agency name:
Agency Id (GA#):
Name of Authorised Agency User:
User id of Authorised Agency User:
Telephone: / DX box no (if applicable):

All fields must be completed.

Service options – select one

Agencies may view their official records at State Records’ Gepps Cross Research Centre free of charge.

View records at Gepps Cross Research Centre

Normal priority loan - agencies may request a normal priority loan of their official records. These requests are processed within 48 hours (excluding delivery time) and apply to requests for up to 20 items. The charge per item is $11.80.

Urgent loan - agencies may request an urgent loan of their official records. These requests are processed within 24 hours (excluding delivery time) and apply to requests for up to 20 items. The charge per item is $16.10.

Delivery/collection options – select one

Send by DX

Collect from Gepps Cross loading bay

Other information

Longer processing times may apply where an agency makes more than one urgent request in a single day, requests more than 20 items, submits a request without adequate descriptive information, or requests items held at State Records’ Collinswood repository.

If a requested record has already been issued to an agency, the above charges still apply. Additional charges apply to urgent retrievals of records stored at State Records’ Collinswood repository.

Records must be returned to State Records’ custody within 90 days. Return dates are printed on the name/address labels found on the records. Agencies may be charged $11.80 for the issue of a Request to Return Official Records Notice.

Loan details

No. / Control No. (GRS/GRG/MRG) / Item No./Date / Name (if applicable) / Box No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Signature of Authorised Agency User*:
Date:

*Please note that loan requests will not be processed without a signature.

Submitting your request

Agencies may either email a copy of the completed form to or fax it to State Records on (08) 8260 6133.

Enquiries

Please direct any loan enquiries to Loan Services at State Records. Telephone (08) 8343 6806 or email .

29 June 2016 Version Draft Page 2 of 2