Required fields are marked with asterisks (*)

Freedom of Information Request Form

The Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) gives you the right to access general records and records with your personal information from municipalities and public-sector organizations in Ontario. Within 30 days of receiving a completed request a decision will be issued with respect to access to records. If a request is received after business hours or on a weekend, it will be reviewed the next business day.

Fee: There is a $5.00 non-refundable fee to file a Freedom of Information Request. Please note that a 1.75% service charge will be applied your credit card.

Additional Fees: Additional fees apply for the preparation, copy of records and administrative research time. The following fees are as set out by MFIPPA:

Photocopying or computer printouts	$0.20 per page
Searching for records	$7.50 per 15 minutes
Record preperation	$7.50 per 15 minutes
Floppy disks or CD's	$10.00 each
Developing computer program	$15.00 per 15 minutes
Certification of documents	$40 each

Questions: If you have any questions or require assistance, please contact Council Services at 519-969-7770 Ext 1256.

Type of Request

Request for:

Records held by LaSalle Police Services - do not submit this form. Please contact Police (519-969-5210).

Access to General Records

Access to Own Personal Information

Correction to Own Personal Information

Requestor Information

First Name

Middle Name

Last Name

Street Address

Apartment/Unit Number

City

Province

Postal Code

Primary Phone Number

Email Address

Details of Request

Please provide a detailed description of requested records, personal information records, or correction of personal information. If your request is for a correction of personal information, please indicate the desired correction and attach any supporting documentation.

Details of Request (see above)

If you are the authorized representative of the Requester, please provide an Authorization and Direction confirming the scope of your representation, and consent provided by the Requester

Browse…

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

Preferred method of access to records

Receive Copy*

Examine Original(s)

*Additional charges may apply for printing and/or shipping costs

Signature

Clear

Date of Signature

Privacy Statement: Personal Information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act and will be used for the purpose of responding to your request. Questions about the collection of this information should be directed to the Director of Council Services/Clerk, Town of LaSalle, 5950 Malden Road, LaSalle, ON, N9H 1S4. Telephone: 519-969-7770