Business Motor Vehicle Collision and Statement Request

This form is to be used for business requests only. For individual requests, click here.

This form is not to be used for Freedom of Information or General Occurrence Requests.

FEE: $56.50 PER REQUEST

Third parties are required to upload a signed authorization or a consent form.

We will review your request to determine your eligibility for MVC reports and/or statements. Once approved, we will contact you via email regarding the mandatory $56.50 fee. Once paid, your request will be complete. Records will be sent via email.

For questions about your request, contact mvc@haltonpolice.ca.

Occurrence Information

Occurrence Number

Occurrence Location

Occurrence Date

Licence Plate (if applicable)

Officer's Name

Badge Number (if known)

Type of Report

Motor Vehicle Collision (including damage to property caused by a vehicle)

Collision Report Statements

Please provide location or cross streets

Purpose of Request and Involvement

Client Information

Business Name

Business Phone Number

Business Email Address

Requestor's Last Name

Requestor's First Name

Requestor's Middle Name

Date of Birth

Home Address

City/Town

Postal Code

Phone Number

Email Address

Pre-Purchased Voucher

If you have a Pre-Purchased Voucher, click the "Yes" box as the answer to the following question and then enter the Voucher Number in the field that appears below. If you do not have a Pre-Purchased Voucher, click the "No" box and then upload a Signed Authorization Form from your insured or client in the field that appears below.

Do you have a Pre-Purchased Voucher?

Yes

Date

Please provide your signature in the box below.

Clear

FEE: $56.50 PER REQUEST

For questions about your request, contact mvc@haltonpolice.ca.

Information on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act and will be used to process and respond to your request for information contained in our files. Questions about this collection should be directed to: Freedom of Information Coordinator, Halton Regional Police Service, 2485 North Service Road West, Oakville, On L6M 3H8, (905) 825-4710.

Form Builder

Business Motor Vehicle Collision and Statement Request

Occurrence Information

Client Information

Pre-Purchased Voucher

FEE: $56.50 PER REQUEST