Freedom of Information and Protection of Privacy (FOIP) Request Form

Applicant Information First Name Last Name Address City Province Postal Code Phone (Primary) Phone (Cell)

Email Address Confirm Email

Details of Requested Information Type of Request General Information Request Personal Information Request

Name of Record

Details

Fees Application Fee *

A $20.00 application fee must accompany all requests (payable on the next page). The processing of this request will not begin unless this fee has been received.

Processing Fee Acknowledgement I understand that additional processing fees may apply.

Verification

Personal information contained on this form is collected pursuant to The Local Authority 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 Access and Privacy Unit.