Request Form
Municipal Closed Meeting Investigation
In accordance with Section 239 of the Municipal Act 2001, as amended.
If mailing, please mark envelope: Personal and Confidential - Complaint under Section
239 of the Municipal Act and send completed form to:
County of Dufferin
Attn: Clerk
55 Zina Street
Orangeville ON L9W IE5
Requestor's name:
City: Postal Code:
Home Phone: Cell Phone:
Date of Closed Meeting:
This should provide as much information as required to explain the nature and background of
the particular occurrence. (i.e. timing, municipal contact, municipal explanation)
Yes No
e you approached Dufferin County staff to solve this manner?
If yes, who?
Date of contact:
Signature: Date:
If you
have any questions, please contact the Clerks Department at 519-941-2816
Personal information contained on this form is collected under section 239.1 of the Municipal
Act, 2001, S.O. 2001, c.25 (as amended) and will be used for the purpose to carry out an
investigation under the Act. Questions about this collection should be directed to the County
of Dufferin Clerk's Office, 55 Zina Street, Orangeville, ON L9W IE5, or 519.9412816, ext 2503.
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