Required fields are marked with asterisks (*)

Access to Records Request Form

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Access to Records Request Form

Type of Request:

Access to General Records

Access to Own Personal Information

Correction to Own Personal Information

If request is for access to, or correction of, own personal information records, indicate if the last name appearing on the records is:

Same as below

or:

Contact Information:

Last Name:

Given Name(s):

Address:

City/Town:

Province:

Postal Code:

Preferred Phone #:

Alternate Phone #:

Email Address:

Details of Request:

Please provide a detailed description of the requested records, personal information, or personal information to be corrected.

Records request: include property address(es) (if applicable) and the names of any staff or position or departments/divisions that may be involved with the records and/or actions related to the subject of the request.
Personal information: if you are requesting access to, or correction of, your personal information, please identify the personal information bank or record containing the personal information, if known.

NOTE: the more detailed and specific you make your request, the more efficiently staff will be able to respond.

Please provide the detailed description:

What are the dates of the information you are requesting, if applicable (yyyy-mm-dd)?

From:

To:

Preferred Method of Access to Records:

Receive electronic copy

Receive paper copy ($0.20/page)

Examine original

Alternate format

If you prefer an alternate method, please describe the format required:

Source of Request:

Individual / Public

Business

Individual (by Agent)

Academic / Researcher

Submission Requirements:

Please ensure this form is completed in full.

You will be instructed in the acknowledgement email whom to contact at City Hall to process the $5.00 access fee by credit card over the phone.

Notice of Collection:

Personal information contained on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act and will be used to process and administrate your request.

Questions about this collection should be directed to the Clerks Division at 519-376-1440 or clerks@owensound.ca.

Signature of Applicant

Clear

Date:

Office Use Only

Date Received:

Request #:

Comments:

Form Builder

Access to Records Request Form

Access to Records Request Form

Contact Information:

Details of Request:

Submission Requirements:

Notice of Collection:

Office Use Only