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Notice of Collection: The personal information recorded on this form is collected and maintained in accordance with MFIPPA - the Municipal Freedom of Information and Protection of Privacy Act and will be used for the sole purpose of processing your request. Questions about the collection of personal information may be addressed to the Records and Information Coordinator, Township of Oro-Medonte, 148 Line 7 South, L0L2E0, Oro-Medonte, Ontario, 705-487-2171.

Confidentiality will be maintained between the complainant and the alleged violator, except where necessary in a court of law. However, should this matter proceed to Court, you may be required to give evidence as a witness and your name and your filed complaint could become public information.

I have read and understand the above terms.

Acknowledgement

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