Request for Access to Records First Name * Last Name * Email * Phone Number * Mailing Address * Street Address * Town/City * Province * Postal Code * Country * Details of Request * Reference or file number, if known Preferred method of access to records * Examine original Receive copy Are you requesting access to another persons personal information? * Yes No Freedom of Information Personal information you provide on this form is collected pursuant to section 26 of the Freedom of Information and Protection of Privacy Act and will only be used for the purpose of processing the business licence application. Your personal information will not be released except in accordance with the Freedom of Information and Protection of Privacy Act. Questions about the collection of your personal information may be referred to Sheena Fraser, Manager of Corporate and Legislative Services (sfraser@pemberton.ca or 604-894-6135). Leave Blank