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Freedom of Information Request

Freedom of Information and Protection of Privacy

Request for Access to Records

Company Name:

Last name:

First name:

Email address:

Day phone no.

Alternate phone no.

Mailing address:
Postal Code:

Details of Requested Information

Information requested (please describe the records you are requesting). Be as specific as possible as this will assist the request process.

Are you requesting access to another person's personal information? (if so, you will be asked to provide either a) that person's signed consent for disclosure or b) Proof of authority to act on that person's behalf
Preferred method of access to records
Date of submission:
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Personal information contained on this form is collected under the Freedom of Information and Protection of Privacy Act and will be used only for the purpose of responding to your request.
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