Motor Vehicle Collision and Statement Request

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

FEE: $56.50 PER REQUEST

You will be notified by email when your request is ready for pick up. IN PERSON pick up is required for identity verification and payment. Pick up is at 2485 North Service Road West, Oakville ONLY.

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

Collision 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

Personal Information

First Name

Last Name

Middle Name

Date of Birth

Home Address

City/Town

Postal Code

Phone Number

Email Address

Date

Signature

Clear

FEE: $56.50 PER REQUEST

You will be notified by email when your request is ready for pick up. IN PERSON pick up is required for identity verification and payment. Pick up is at 2485 North Service Road West, Oakville ONLY.

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

Motor Vehicle Collision and Statement Request

Collision Information

Personal Information

FEE: $56.50 PER REQUEST