Freedom of Information

Request Form

under the Freedom of Information and Protection of Privacy Act/ Municipal Freedom of Information and Protection of Privacy Act Please Note: A $5.00 application fee is required for all requests.

Request for *

Access to General Records

Access to Own Personal Information

Correction to Own Personal Information

Name of Institution request made to *

If request is for access to, or correction of, own personal information records: *

Last name appearing on records

Please select *

Mr

Mrs

Ms

Miss

First Name *

Last Name *

Middle Name *

Address: (Street/Apt. No./P.O. Box/R.R. No.) *

City/Town *

Province *

Postal Code *

Telephone Number (Day) *

Telephone Number (Evening) *

Detailed description of requested records, personal information or personal information to be corrected. (If you are requesting access to or correction of your personal information, please identify the personal information bank or record containing the person information, if known.) *

Note: If you are requesting a correction of personal information, please indicate the desired correction, and if appropriate, attach any supporting documentation. You will be notified if the correction is not made and you may require that a statement of disagreement be attached to your personal information.

Preferred method of access to records *

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