Request To Correct Personal Information

Personal information on this form is collected in accordance with New Brunswick’s Right to Information and Protection of Privacy Act (“Act”).

Instructions

About You - In this section of the form, please include:

  • your last name, first name, and preferred title; the name of the company or organization you are representing, if applicable;
  • your complete mailing address and daytime and evening telephone numbers so that the public body can contact you about the request; and
  • a fax number or e-mail address, if any, where correspondence may be sent.

About Your Request

  • Please check which person’s information you would like to correct.

About the Information You Want to Correct

  • Please give your full name and any other names that you previously used and any identifying number that relates to the records in question.
  • If you are requesting a correction to another person’s information, please attach proof that you can legally act for that person.  This authorization can be in the form of a signed letter, a Power of Attorney, or other legislated authorization.  Please see section 79 of the Act for more details.
  • Please be specific as to what exactly needs to be corrected.  If you need more space, please continue your description on a separate sheet of paper and attach it to this form.

Fees

  • There are no fees when making a request to correct personal information.
What kind of information do you want to correct? (Please check one.)
(Please attach proof that you can legally act for that person. This authorization can be in the form of a signed letter, a Power of Attorney, or other legislated authorization. Please see section 79 of the Act for more details.)
One file only.
32 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.
Please provide as much detail as possible. Be sure to give the complete name that is in the records and any identifying number related to the records in question.
Please attach any documents that support your request.

Supporting Documents

One file only.
32 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx..
One file only.
32 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx..
One file only.
32 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx..
One file only.
32 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx..

Terms & Conditions

I certify that the statements made in this application are true and complete to the best of my knowledge. I am aware that misrepresentation or falsifications may result in rejection of my application.

I Agree
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