Your ref [their reference]
Date today
Subject: Privacy complaint — [the agency] — [your full name], DOB [your date of birth]
To the Office of the Australian Information Commissioner
Complainant: [your full name], DOB [your date of birth], [your email]
Respondent: [the agency]
Their reference: [their reference]
What happened and when
On [the date they received it] I requested access to my personal information under APP 12. [what happened].
My complaint to the respondent
I complained in writing to [the agency] and asked for the ground in APP 12.3 relied on and the written reasons APP 12.9 requires. A copy is attached, with every reply. More than 30 days have passed.
What the respondent has done to fix it
Nothing that answers the request.
The outcome I want
[what you want done]
[your full name]
today