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Freedom of Information Request

Each request must be accompanied by a $5.00 fee payable to the Municipality. We accept debit, cash, or cheque at our front counter. Contact our Clerk at clerk@westelgin.net or call 519-785-0560 ext. 222, if you have any questions about filling out this form.

Personal information contained on this form is collected pursuant to Municipal Freedom of Information and Protection of Privacy Legislation and will be used for the purpose of response to your request. Questions about the collection should be directed to the Clerk, at 22413 Hoskins Line, Rodney, ON 519-785-0560 or clerk@westelgin.net. This information will be kept private and confidential unless otherwise required by law.

Please select what this request is for:

Access to General Records

Access to Own Personal Information

Correction to Own Personal Information

If the request is for access to or correction of personal information records, please state the name appearing on record(s):

Last Name:

First Name:

Address:

City/Town:

Postal Code:

Phone Number:

E-mail Address:

Detailed description of records requested, personal information or personal information to be corrected

Preferred Method of Examining Records:

Examine Original

Receive Copy

Signature of Person Requesting Records:

I verify that the information provided is true and correct to the best of my knowledge.

Date:

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Freedom of Information Request