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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:

First Name

Middle Name

Last Name

Street Address

City

Province

Postal Code

Telephone Number (Day):

Telephone Number (Evening):

Email Address

If requesting information on behalf of another person, include letter with their signature authorizing you to make the request AND a piece of identification with their signature.

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Detailed Description of Requested Records, Personal Information or Personal Information to be Corrected

Preferred Method of Access to Records:

Examine Original

Receive Copy

Personal Information contained on this form is collected pursuant to the Freedom of Information and Protection of Privacy Act/Municipal Freedom of Information and Protection of Privacy Act and will be used for the purpose of responding to your request. Questions about this collection should be directed to the Freedom of Information and Privacy Co-ordinator at the institution where the request is made.

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Upload Electronic Signature if desired

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First and Last Name of Person Submitting Form

Date:

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Concerns, Complaints and Compliments

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Freedom of Information Request Form