Request Form

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

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

Request for: Name of Institution request made to: Access to General Records Access to Own Personal Information Correction to Own Personal Information

OTTAWA POLICE SERVICE

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

Last name appearing on records: same as below, or:

Last Name:

First Name: Middle Name: DOB:

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

Province: Postal Code:

Telephone Number (Day): ( ) Telephone Number (Evening): ( )

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.)

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.

Signature: Da te:

EACH REQUEST MUST BE ACCOMPANIED BY THE $5.00 APPLICATION FEE. CHEQUE OR MONEY ORDERS SHOULD BE MADE PAYABLE TO THE TREASURER OF THE CITY OF OTTAWA.

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 institution where the request is made.

SUMMARY OF FEES FOR INFORMATION REQUESTS UNDER THE MUNICIPAL FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT If you request information under the Municipal Freedom of Information and Protection of Privacy Act you may be required to pay certain fees. The rules regarding the payment and amount of fees are set out in the Act and its regulations. Typical fee charges are summarized below. If you are requesting information about yourself, your request is considered a “personal information request”. All other requests for information, whether about a person other than yourself or about a government program or activity are considered “General information requests”. General information requests are charged different fees than personal information requests. Please note that a formal request does not guarantee the release of the requested information; however, will guarantee a decision. FEE CHARGES FOR REQUESTS FOR PERSONAL INFORMATION *Requests made by yourself or on your behalf with your consent* The following fees may apply to requests for your personal information: Application fee: $5.00 - Must be paid when you submit your request; General Occurrence Report $57.00 – Access to your own personal information only Motor Vehicle Accident $222.00 – Approved Ministry of Transportation form Photocopying: $0.20 - page Computer Programming: $15.00 - 1/4 hour if needed to develop program to retrieve

information; CD/DVDs: $29.00 - for each disk FEE CHARGES FOR REQUESTS FOR GENERAL INFORMATION *Please see the attached Fee Schedule for all other applicable fees* The following fees may apply to requests for general information: Application fee: $5.00 - Must be paid when you submit your request; Search time: $7.50 - 1/4 hour required to search and retrieve records; Record Preparation: $7.50 - 1/4 hour required to prepare records for release; Photocopying: $0.20 - page Computer Programming: $15.00 - 1/4 hour if needed to develop program to retrieve

information; CD/DVDs: $29.00 - for each disk If applicable, a fee estimate will be sent to you. If the estimate of fees to be paid is $100.00 or more, you may be required to pay a 50% deposit. For further information about fees that may be charged, contact the Freedom of Information and Privacy Coordinator at your local municipal office or at the offices of most local boards.