Required fields are marked with asterisks (*)

ACCESS REQUEST

Municipal Freedom of Information and Protection of Privacy Act (MFIPPA)

Please Note:

Online submissions only take Visa and Mastercard
A $5.00 application fee is required for all requests. Additional processing fees may apply.
This Access Request will be processed in accordance with the timelines set out in MFIPPA upon receipt of the $5.00 application fee.

The record(s) you request may contain personal information of individuals other than yourself. Such personal information can only be released with the consent of those individuals.

Can the GPS contact these individuals to ask for consent to release their personal information?

Yes

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

The last name appearing on the records is

same as below

or other last name

Your Name

Surname

First Name

Middle Name

Date of Birth

Contact information (A receipt will ONLY be provided if you submit an e-mail address)

Telephone and e-mail

E-mail address

Telephone number

Your home address

Please note: We do not send personal information through the mail. We will contact you to verify your identity and arrange to release your response to you electronically.

Unit/Number

Street

City

Postal Code

Provide as much detail as you can of the record(s) you are requesting (i.e. incident number, dates, type of incident, location, names of individuals involved)

Attach any supporting documentation

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

Signature

Clear

foicoordinator@guelphpolice.ca