Request Form for City of Ottawa Documentation
in Multiple Format

Name _________________________________________________________________

Address ________________________________________________________________
_______________________________________________________________________

Telephone __________________________ Fax Number ______________________

E-mail__________________________________________________________________

Name of Document _______________________________________________________

Name and Date of Event ___________________________________________________

Language Requested (please circle one): English French

Format Requested: e.g. Braille, html, text etc. (please indicate any specific technical needs) ________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Additional information regarding the request or document (i.e. time factors such as a set public consultation period) ______________________________________________
_______________________________________________________________________
_______________________________________________________________________

THANK YOU FOR YOUR INTEREST IN THE CITY OF OTTAWA

RETURN THIS FORM TO:

Fax: 613-560-1380
E-mail: erin.bell@ottawa.ca
Mail: Secretariat Services Branch
City of Ottawa
110 Laurier Avenue West
Ottawa, ON K1P 1J1
Phone: 613-580-2424 Ext. 28090
TTY: 613-580-2401

Personal information on this form is collected under the authority of section 367(1) of the Municipal Act, R.S.O. 1990, c. M.45. It will be used to provide a document or information produced by the City of Ottawa, as requested. Questions about this collection may be directed by mail to the City Clerk, City of Ottawa, 110 Laurier Avenue West, Ottawa, ON, K1P 1J1.

This document is available upon request in an alternate format