Access Request for Records Held by The City of Port Coquitlam

Freedom of Information and Protection of Privacy Online Form

Personal information entered on this form is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FOIPPA) and will be used to respond to your request. If you have any questions or concerns about how your information will be used, contact the City’s Records and FOIPPA Administrator at 604.927.5250 or corporateoffice@portcoquitlam.ca

Last Name *

First Name *

Title (optional) Miss Mrs. Ms. Mr.

Address *

Address

Address

Address

City

City

Province

Province

Postal Code

Postal Code

Phone Number *

Email Address

Preferred method of access to records * Via email (Please provide your email above) Via mail Examine original Other Preferred method of access to records

Details of Requested Information *

Information Requested (Please describe the records you are requesting. Be as specific as possible, as this will assist the request process. Please specify, if any, reference or file number(s) known

Are you requesting access to another person's personal information? * No Yes

If so, please attach, as appropriate: (a) that person's signed consent for disclosure, or (b) proof of authority to act on that person's behalf.

File Upload

Drop a file here or click to upload Choose File

Maximum upload size: 209.72MB

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Other Request Methods
You can submit a request by printing the pdf version of this form and submitting it via email or mailing it to Corporate Office, City of Port Coquitlam – 2580 Shaughnessy St. Port Coquitlam, BC V3C 2A8.

Privacy
Personal information contained on this form is collected under The Freedom and Information and Protection of Privacy Act and will be used only for the purpose of responding to your request.

Fees
There may be associated costs with information requests. The Freedom and Information and Protection of Privacy Act permits fees to be charged for locating, retrieving, producing, preparing for disclosure, shipping and handling, and providing a copy of the record(s) requested. The first three hours are free for non-commercial requests.