APPLICATION TO OBTAIN COPY OF CCTV FOOTAGE

• Document No.

• APPLICATION TO OBTAIN COPY OF CCTV FOOTAGE

• DexusProperty Group 452 Flinders Street Melbourne 3000

All Applicants, please read the following Information: DECLARATION: 1. Acknowledge that any CCTV footage released to me has been acquired from Dexus Property Group, Site specific: 452 Flinders Street Melbourne 3000 2. I acknowledge that any CCTV footage released to me will only be used for the purposes pertaining to the investigation surrounding the below listed incident 3. I acknowledge that images relating to other persons contained in any footage released to me will not be used for any other purpose other than an Official Police Investigation if required (Police meaning state and or Territories/ Federal) 4. I will not allow copies of any CCTV footage released to me to be reproduced except for Court Procedings/ Purposes 5. I will not show or display any image or release it publicly without the written consent of Dexus Property Group in conjunction with State Police Agencies 6. I will keep the footage released to me in a secure manor when not being used 7. I HAVE THE AUTHORITY TO MAKE THIS REQUEST AND TO SIGN THIS FORM ON BEHALF OF:

• Name of Government Body (please select response):

  Select Victoria Police (VICPOL) Australian Criminal Intelligence Commission (ACIC) Australian Federal Police (AFP) South Australia Police Western Australia Police Northern Territory Police Queensland Police New South Wales Police Tasmania Police

  • Victoria Police (VICPOL)
  • Australian Criminal Intelligence Commission (ACIC)
  • Australian Federal Police (AFP)
  • South Australia Police
  • Western Australia Police
  • Northern Territory Police
  • Queensland Police
  • New South Wales Police
  • Tasmania Police

• Applicants Information

• Name of requesting officer:

• Rank of requesting officer:

• Station/ Local Area Command:

• Telephone No.

• Officers Signature

  Sign

• Date of Application:

Incident Information:

• Date & Time of Incident:

  Date

• Location of Incident:

• Detail of Incident:

Site Security Information

• Name of individual who reviewed CCTV:

• Name of individual who Burned CCTV:

• Date CCTV requested:

• CCTV inclusive of still photos?

  Yes

  No

  N/A

• CCTV location (Camera ID)

  Select Lift 1 Lift 2 Lift3 Lift 4 Lift 5 Lift 6 Lift 7 Lift 8 Lift 9 Lift 10 Lift 11 Lift 12 Goods Lift 13 C-P Lift 14 C-P Lift 15 A-H Main Entry C-P Entry C-P Exit Flinders Lane Flinders Street Goods Lift Lobby L15 PTZ L-Dock Entry LG Bike Cage Loading Dock Camera Lobby North Lobby South Lv 15 Balcony East Lv 15 Balcony Nth Lv 15 Balcony South Lv 15 North Balcony Lv 20 Cooling Tower Nth Lv 20 Cooling Tower Sth Lv 20 PTZ Mezzanine North Mezzanine South Plaza North Plaza South S.C.R Entry

  • Lift 1
  • Lift 2
  • Lift3
  • Lift 4
  • Lift 5
  • Lift 6
  • Lift 7
  • Lift 8
  • Lift 9
  • Lift 10
  • Lift 11
  • Lift 12
  • Goods Lift 13
  • C-P Lift 14
  • C-P Lift 15
  • A-H Main Entry
  • C-P Entry
  • C-P Exit
  • Flinders Lane
  • Flinders Street
  • Goods Lift Lobby
  • L15 PTZ
  • L-Dock Entry
  • LG Bike Cage
  • Loading Dock Camera
  • Lobby North
  • Lobby South
  • Lv 15 Balcony East
  • Lv 15 Balcony Nth
  • Lv 15 Balcony South
  • Lv 15 North Balcony
  • Lv 20 Cooling Tower Nth
  • Lv 20 Cooling Tower Sth
  • Lv 20 PTZ
  • Mezzanine North
  • Mezzanine South
  • Plaza North
  • Plaza South
  • S.C.R Entry

• POSITION TITLE

  Select SECURITY MANAGER ACTING SECURITY MANAGER SECURITY OFFICER SERVICE PROVIDER SENIOR FACILITIES MANAGER

  • SECURITY MANAGER
  • ACTING SECURITY MANAGER
  • SECURITY OFFICER
  • SERVICE PROVIDER
  • SENIOR FACILITIES MANAGER

• Signature:

  Sign