Access/Correction Request

Freedom of Information and Protection of Privacy

Request for :

Access to General Records

Access to Own Personal Information

Correction of Own Personal Information

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

Last name appearing on records: same as below OR:

Details

Last Name: First Name: Middle Name:

Mr. Ms Miss Mrs. Dr.

Address: City or Town: Province:

Postal Code: Telephone(Daytime): Telephone(Evening):

Fax: E-mail Address:

Detailed description of requested records, personal information records 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 personal information, if known):

Timeframe of Search :

Records dated from through to the date this request is received.

Location of Search :

Please specify the Faculty, Service or office that you would like searched :

Preferred method of access to records:
Examine Original
Receive Copy

Signature

Day/ Month/ Year

For Institution Use Only

Date Received

Day/ Month/ Year

Request Number:

Comments:

Personal information contained on this form is collected pursuant to Freedom of Information and Protection of Privacy legislation and will be used for the purpose of responding to your request. Questions about this collection should be directed to the Access to Information and Privacy Coordinator, Access to Information and Privacy Office, University of Ottawa, Tabaret Hall, M383-550 Cumberland Street, Ottawa, Ontario, K1N 6N5.