Required fields are marked with asterisks (*)

Access/Correction Request

Freedom of Information and Protection of Privacy Act/Municipal Freedom and Protection of Privacy Act

Request for:

Access to General Records

Access to Own Personal Information

Correction of Own Personal Information

Name of the Institution request made to:

Kawartha Conservation
277 Kenrei Road
Lindsay, ON K9V 4R1

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

Same as below

Other

Last Name:

First Name:

Middle Name

Address (Street/Apt. No/P.O. Box No./R/R. No.)

City or Town

Province

Postal Code

Telephone Number

Please provide a 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 personal 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.

Supporting documents

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

Personal information contained on this form is collected pursuant to the Freedom of Information and Protection of Privacy Act/Municipal Freedom of Information and Protection of Privacy Act and will be used for the purpose of responding to your request. Questions about this collection should be directed to the Freedom of Information and Privacy Co-ordinator at the insitiution where the request is made.

Payment Page

Access/Correction Request

Name of the Institution request made to: