Template (customize the bracketed sections)
[Your Name]
[Your Address]
[Your Email]
[Date]
Privacy Officer
[Organization Name]
[Organization Address]
Re: Access to Personal Information Request
Dear Privacy Officer,
I am writing to request access to all personal information your organization holds about me, pursuant to [PIPEDA / applicable provincial law / FIPPA / etc.].
My identifying details are:
- Full legal name: [Your Name]
- Date of birth: [DD/MM/YYYY]
- Address: [Your Address]
- Account or file number (if applicable): [Number]
I am specifically requesting records from [start date] to [end date] relating to [describe the records, e.g., my account history, communications, transaction records, etc.].
Please provide the records in electronic format where possible. I understand the legal response time is [30 days under PIPEDA / 30 days under FIPPA / etc.].
Please confirm receipt of this request in writing. If you need additional information to process this request, please contact me at the email above.
Sincerely,
[Your Name]
Attached: copy of government-issued photo identification.
Tips
Customize these elements:
- Identify the correct statute for your jurisdiction and the type of organization.
- Be specific about the records you want.
- Include proof of identity but redact sensitive details (driver's licence number, etc.) that are not needed for verification.
- Send by a method that creates a record (email with read receipt, or registered mail).