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Request for a Municipal Closed Meeting Investigation

Section 239 - Municipal Act 2001, as amended

Completed applications must be submitted to the Municipal Clerk, The Municipality of Port Hope, 56 Queen St. Port Hope, ON L1A 3Z9

Part 1: Requestor

Applicants Full Name:

Telephone Number:

Address:

Email Address:

Do you consent having your identity revealed during the investigation?

Yes

Part 2: Meeting Particulars

Name of Municipality:

Date of Closed Meeting:

Background: (Please provide as much information as possible to explain the nature and background of the particular occurrence.)

Part 3: Action

Have you approached the municipal staff to resolve the matter?

Yes

If Yes, who?:

Date of contact:

Other activities the requestor has undertaken to resolve the matter:

Any other details deemed relevant by the requestor?

Requestor Signature

Clear

Todays Date:

The personal information on this form is collected under legal authority of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O 1990, Chapter M.56.The information will be used for the purpose of responding to your request. Questions about this collection can be directed to the Director of Corporate Services/ Clerk 56 Queen St. Port Hope ON L1A 3Z9 or by telephone at 905-885-4544

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Request for a Municipal Closed Meeting Investigation

Part 1: Requestor

Part 2: Meeting Particulars

Part 3: Action