How to Make an Access to Information Request

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Surname

First Name

Date

Organization (Indicate N/A if not applicable)

Address

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Daytime Telephone #

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I would prefer to *

examine a copy of the records

receive a copy of the records

If possible, I wish to receive the requested records in the following format:

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My personal information

General information

I wish to obtain access to the following information/records (please be specific) *

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