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Freedom of Information and Protection of Privacy Access / Correction Request

First Name

Last Name

Mailing Address

City

Province or State

Postal Code

Telephone

Request for

Access to General Records

Access to Own Personal Information

Correction of Own Personal Information

Preferred method of access to records

Examine original

Receive copy

Detailed description of requested records, personal information records or personal information to be corrected, including the timeframe of the records.

Note: if you wish to submit any supporting documentation, please attach it below.

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Personal information contained on this form is collected under the authority of the Municipal Act, R.S.O. 1990 and will be used to process this form.

Questions about the collection should be directed to: Freedom of Information Co-Ordinator, Office of the Clerk, P.O. Box 1044, 3540 Schmon Parkway, Thorold, Ontario, L2V 4A7, 905-227-6613.

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