Attention This form requires printing and submission by mail with the $5.00 application fee to:Access to Information UnitWaterloo Regional Police ServicePO Box 3070200 Maple Grove RoadCambridge, ON N3H 5M1 Access/Correction RequestRequired fields are marked with asterisks (*)This Access/Correction Request will be processed in accordance with the timelines set out in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and Regulations. The timeline to respond to your inquiry begins with the receipt of the $5.00 application fee.Personal information contained on this form is collected under section 17 of the Municipal Freedom of Information and Protection of Privacy Act and will be used to respond to your request. Questions about this collection should be directed to the Access to Information Unit at 519-570-9777 extension 8514 or email foi@wrps.on.ca. Request for Correction to Own Personal Information Access to Own Personal Information Access to General Records Requestor Contact Information Surname (last name) Surname Appearing on Records (If Different) Given name(s) Date of Birth Email Address Contact Phone Number? Can a message be left at this number? Yes No Requestor Contact Information Number Street Name Apartment City Prov/Terr./State Postal Code/ZIP Code* Request DetailsDetailed description of requested records, personal information or correction of personal information: (If request is for correction of personal information, please indicate the desired correction and attach any supporting documentation)* Request The record(s) you requested may contain the personal information of individuals other than yourself. Do you wish these individuals be contacted to try and obtain their consent to disclose their information? Yes No Preferred method of access to records Examine Originals (on-site only) Receive copy Delivery Method Mail Pickup in Person Once you press submit, the completed form will be emailed to you. Please print this form and submit it via postal mail or in person at the Police Reporting Centre at 150 Maple Grove Road, Cambridge. A completed request requires the following three items: A completed request form;A copy of an acceptable form of ID and;The $5.00 application fee. The timeline to respond to your inquiry begins with the receipt of the application fee. Mailing AddressWRPS Access to Information Unit PO Box 3070 200 Maple Grove Road Cambridge, ON N3H 5M1 Leave this field blank