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Disclosure Request - AMPS

I hereby request access to all records and information pertaining to my penalty notice:

Penalty Notice Information

Penalty Notice Number

Date of Issuance of Penalty Notice

Vehicle License Plate No. (if applicable)

Date of Hearing Appeal

Contact Information

Name

Address

Phone Number

Email Address

I would like to receive disclosure via:

Pick-up at Administrative Office (1123 North Shore Road)

Signature of Applicant

Clear

To the extent that the following information constitutes personal information as defined in the Municipal Freedom of Information and Protection of Privacy Act R.S.O. 1990, Chapter M.56 as amended, the information is subject to the provisions of that Act and will be used for the purposes indicated or implied by this form. Questions about this process should be directed to the Clerk's Department.

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