Disclosure Request Form

Disclosure Request Form

Disclosure for parking penalties can only be requested once a hearing has been set. Please complete the entire form for your request to be processed in a timely manner. (must submit request 10 days before the hearing date)
Request date*

MonthDayYear
Date
Who is requesting disclosure?*

OwnerLegal representative (Lawyer/Licensed Paralegal)Authorized Agent (i.e. friend, relative and must complete Client-Agent Authorization Form)
Owner information
Name*

First NameLast Name
Address*
City*
Province*
Postal code*
Telephone number*
Please enter a valid phone number.
Fax number
Please enter a valid fax number.
Email*
example@example.com
Offence and hearing information
Offence(s)*
Offence number(s)*
Offence date*

MonthDayYear
Date
Hearing date*

MonthDayYear
Date
Is disclosure being requested by someone other than the defendant?*

YesNo
Legal Representative/Authorized Agent

Complete ONLY if disclosure is being requested by someone other than the defendant.
Legal Representative/Authorized Agent*

First NameLast Name
Phone number*
Please enter a valid phone number.
Fax number
Please enter a valid fax number.
Email*
example@example.com
Disclosure can only be released to the defendant, Lawyer or Licensed Paralegal. An Authorized Agent must complete a Client-Agent Authorization Form before disclosure can be released.
Completed Client-Agent Authorization Form *

Cancelof
How would you like to receive disclosure?*

EmailPick up in person (you will be notified when disclosure is ready for pick up)
Collection of personal information
Collection of Personal Information is being collected and will be used to track, determine action, and respond to individuals regarding parking penalty notices issued by the City of Guelph. Personal Information, as defined by Section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) is collected under the authority of the Municipal Act, 2001, and in accordance with the provisions of the MFIPPA. If you have any questions about the collection, use or disclosure of this personal information, please contact the City’s Information and Access Coordinator at 519-822-1260 extension 2349, or email privacy@guelph.ca.
Should be Empty:

Disclosure Request Form

Owner information

Offence and hearing information

Legal Representative/Authorized Agent

Collection of personal information