Required fields are marked with asterisks (*)

MFIPPA Request Form

Please Note: a $5.00 application fee is required for all requests.

Request for:

Access to General Records

Access to Own Personal Information

Correction to Own Personal Information

Name of Institution request made to:

If request is for access to, or correction of, own personal information records:

Last name appearing on records:

Same as below

Other

Last Name

First Name

Middle Name

Mailing Address

City/Town

Province

Postal Code

Phone Number (Day)

Phone Number (Evening)

Email Address

Detailed description of requested records, personal information or personal information to be corrected. (If you are requesting access to or correction of your personal information, please identify the personal information bank or record containing the person information, if known).

Detailed Description

Note: If you are requesting a correction of personal information, please indicate the desired correction, and if appropriate, attach any supporting documentation. You will be notified if the correction is not made and you may require that a statement of disagreement be attached to your personal information.

Additional Documentation

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Preferred method of access to records

Examine Original

Receive Copy

Personal Information

Personal information collected from applications is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act, and will be used for recreation the purpose of responding to your request. Questions about the collection of information should be directed to the Clerk at 217 Harper Road, Perth, ON, K7H 3C6 or by phone at 613-267-5353 ext. 130 or by email at clerk@tayvalleytwp.ca.

By clicking "Accept" below, I confirm that I have read, understood and agree to the information above

Stay up to date on the municipality's activities, events, programs and operations by subscribing to our eNews