Request to Correct Personal Information

About You

First Name

Last Name

Name of company or organization

(where applicable)

Mailing Address

City or Town

Province

Postal Code

Home Telephone #

Work Telephone #

Fax #

Whose information do you want to correct?

Your own personal information

Information about another individual (Please attach proof of authorization.)

To which Town department are you making your request?

What personal information needs to be corrected?

Please provide as much detail as possible. Be sure to give the complete name that is in the records and any identifying number related to the records in question.

What correction(s) do you want to make and why?

Please attach any documents that support your request.

Date

Please attach any additional information.

Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx odt.