This consolidation is unofficial and is for reference only.

For the official version of the regulations, consult the original documents on file with the Registry of Regulations , or refer to the Royal Gazette

Part II .

Regulations are amended frequently.

Please check the list of Regulations by Act to see if there are any recent amendments to these regulations filed with the Registry that are not yet included in this consolidation.

Although every effort has been made to ensure the accuracy of this electronic version, the Registry of Regulations assumes no responsibility for any discrepancies that may have resulted from reformatting.

This electronic version is copyright © 2015, Province of Nova Scotia , all rights reserved. It is for your personal use and may not be copied for the purposes of resale in this or any other form.

Freedom of Information and Protection of Privacy Regulations

made under

Section 49 of the

Freedom of Information and Protection of Privacy Act

S.N.S. 1993, c. 5

O.I.C. 94-537 (June 28, 1994, effective July 1, 1994), N.S. Reg. 105/94

as amended to O.I.C. 2015-102 (March 31, 2015, effective April 1, 2015), N.S. Reg. 185/2015

Table of Contents

Citation

Definitions

Application for access to records

Request for correction of personal information

Anthropological and heritage sites

Fees

Consent to disclosure of information

Consent to use of personal information

Disclosure for research purpose

Notice of disclosure

Request for review

Appeal to Supreme Court

Notice to Third Parties

Interpretation of administrative proceeding

Interpretation of terms with respect to local public bodies

Time limit for compliance by public body

Compliance by public body with time limit

Definitions of words and expressions with respect to the definition of “background information”

Definition of expression “officers of the public body”

Form 1—Application for Access to a Record

Form 2—Request for Correction of Personal Information

Form 3 —Consent to Disclosure of Information

Form 4—Consent to use of Personal Information

Form 5—Agreement

Form 6—Notice of Disclosure

Form 7—Request for Review

Form 8—Request for Review

Form 9—Appeal

Form 10—Appeal

Form 11—Appeal

Citation

1 These regulations may be cited as the “Freedom of Information and Protection of Privacy

Regulations”.

Definitions

2 In these regulations

(a) “Act” means the Freedom of Information and Protection of Privacy Act ;

(b) “appellant” means a person who appeals to the Supreme Court pursuant to

Section 41 of the Act;

(c) “applicant” means a person who makes a request pursuant to subsection 6(1) of

the Act for access to a record or pursuant to subsection 25(1) of the Act for

correction of personal information;

(d) “application” means a request for access to a record pursuant to subsection 6(1)

of the Act.

Application for access to records

(1) An application

(

a) must state that the application is made pursuant to the Act;

(

b) may be in Form 1.

(2) If an individual familiar with the subject matter is unable to identify a record for

which an application is made, the head of the public body shall so advise the

applicant and permit the applicant to amend the application to provide additional

particulars.

Request for correction of personal information

(1) A request for correction of personal information pursuant to subsection 25(1) of the

Act

(

a) must

(

i) be made in writing,

(ii) state that the request is made pursuant to the Act, and

(iii) provide sufficient detail to enable an individual familiar with the subject

matter to identify the personal information and the proposed correction of

the personal information;

(

b) may be in Form 2.

(2) If an individual familiar with the subject matter is unable to identify the personal

information with respect to which a request for correction is made, the head of the

public body shall so advise the applicant and permit the applicant to amend the

application to provide additional particulars.

Anthropological and heritage sites

5 For the purposes of

Section 19 of the Act,

(

a) a site has anthropological value if it contains an artifact or other physical

evidence of past habitation or use that has research value; and

(

b) a site has heritage value if it is the location of a traditional societal practice for

a living community or it has historical, cultural, aesthetic, educational,

scientific or spiritual meaning or value for the Province or for a community,

including an aboriginal people.

Fees

(1) An applicant who makes a request for access to a record pursuant to subsection 6(1)

of the Act must pay to the public body an application fee in the amount of $5.00 .

Subsection 6(1) amended: O.I.C. 2009-343, N.S. Reg. 262/2009.

(2) When no search fee or reproduction fee is determined by an enactment other than the

Act, the fees payable for services under the Act shall be the actual costs to the public

body of providing the following services:

(

a) locating, retrieving and producing the record;

(

b) preparing the record for disclosure;

(

c) shipping and handling the record;

(

d) providing a copy of the record.

(3) Despite subsection (2), the fees for services mentioned in subsection (2) shall not

exceed the following amounts:

(

a) for locating and retrieving a record, $15.00 for each half-hour of person time

after the first 2 hours , rounded down to the nearest half-hour;

Clause 6(3)(

a) amended: O.I.C. 2002-163, N.S. Reg. 52/2002; O.I.C. 2002-351, N.S. Reg. 101/2002;

O.I.C. 2007-474, N.S. Reg. 378/2007.

(

b) for producing a record manually, $15.00 for each half-hour of person time,

rounded down to the nearest half-hour;

Clause 6(3)(

b) amended: O.I.C. 2002-163, N.S. Reg. 52/2002.

(

c) for producing a record from a machine readable record, the actual cost incurred

for computer usage and for developing a computer program to produce the

record;

(

d) for preparing a record for disclosure and handling a record, $15.00 for each

half-hour of person time, rounded down to the nearest half-hour;

Clause 6(3)(

d) amended: O.I.C. 2002-163, N.S. Reg. 52/2002.

(

e) for shipping a record, the actual costs of shipping method chosen by applicant;

(

f) where the record is stored or recorded in printed form and can be copied on

conventional photocopying equipment, twenty cents a page for providing a

copy of the record;

(

g) where the record is stored or recorded in a manner other than that referred to in

clause (

f) or cannot be reproduced on conventional photocopying equipment,

the actual cost of reproduction for providing a copy of the record.

(4) Subsections (1) and (2) do not apply to a request for the applicant’s own personal

information.

(5) Where an enactment other than the Act determines that a search fee or reproduction

fee must be charged respecting access to a record, the head of the public body to

whom an application is made must charge the applicant the search fee or

reproduction fee under the enactment.

(6) Where an applicant is not required to pay and has not paid an estimated fee in

advance pursuant to subsection 11(6) of the Act and the head of the public body has

not waived the payment of the fee, the applicant must pay the fee for services when

access to a record is given or refused.

Subsection 6(6) amended: O.I.C. 95-591, N.S. Reg. 130/95.

(7) A head of a public body shall refund to an applicant any fee paid for services

pursuant to subsection 6(2) of the Act that is subsequently waived.

(8) Where the actual cost of responding to an application is less than the estimated fee

paid by an applicant pursuant to subsection 11(6) of the Act, the head of the public

body that responds to the application must refund the difference to the applicant.

(9) The following are prescribed as additional circumstances in which a head of a public

body may waive the payment of all or any part of a prescribed fee:

(

a) whether the applicant is given access to the record;

(

b) if the amount of the payment would be five dollars or less, whether the amount

of the payment is too small to justify requiring payment.

Subsection 6(10) added: O.I.C. 2002-351, N.S. Reg. 101/2002; repealed: O.I.C. 2007-474, N.S. Reg. 378/2007.

Consent to disclosure of information

(1) The consent of a third party to a public body disclosing information pursuant to

subsection 21(4) of the Act may be in Form 3.

(2) The consent of an individual to a public body disclosing any of the individual’s

personal information pursuant to clause 27(

b) of the Act may be in Form 3.

Consent to use of personal information

8 For the purposes of clause 26(

b) of the Act, the consent of an individual to a public body

using personal information

(

a) must

(

i) be in writing,

(ii) identify the information, and

(iii) specify to whom the information may be disclosed and how the

information may be used;

(

b) may be in Form 4.

Disclosure for research purpose

9 An agreement pursuant to clause 29(

d) of the Act must be in Form 5 and include the

following conditions:

(

a) the person shall use the information only for a research purpose set out in the

agreement or for which the person has written authorization from the public

body;

(

b) the person shall name in the agreement any other persons who will be given

access to personal information in a form in which the individual to whom it

relates can be identified;

(

c) before disclosing personal information to other persons under clause (b), the

person shall enter into an agreement with those persons to ensure that they will

not disclose it to any other person;

(

d) the person shall keep the information in a physically secure location to which

access is given only to the person and to the persons given access under clause

(b);

(

e) the person shall destroy all individual identifiers in the information by the date

specified in the agreement;

(

f) the person shall not contact any individual to whom personal information

relates, directly or indirectly, without the prior written authority of the public

body;

(

g) the person shall ensure that no personal information will be used or disclosed

in a form in which the individual to whom it relates can be identified without

the written authority of the public body;

(

h) the person shall notify the public body in writing immediately if the person

becomes aware that any of the conditions set out in this

section have been

breached.

Notice of disclosure

10 A notice of disclosure pursuant to subsection 31(3) of the Act must be in Form 6.

Request for review

(1) A written request by an applicant for a review pursuant to subsection 32(1) of the

Act may be in Form 7.

(2) A written request by a third party for a review pursuant to subsection 32(2) of the

Act may be in Form 8.

Subsections 11(1) and 11(2) amended: O.I.C. 95-591, N.S. Reg. 130/95.

Appeal to Supreme Court

(1) An appeal to the Supreme Court pursuant to

Section 41 of the Act by

(

a) an applicant mentioned in subsection 32(3) of the Act shall be in Form 9;

(

b) an applicant mentioned in subsection 41(1) of the Act shall be in Form 10;

(

c) a third party mentioned in subsection 41(1) of the Act shall be in Form 11.

(2) The appellant must complete Part A of Form 9, 10 or 11 and must file it with the

prothonotary of the Supreme Court of Nova Scotia who must complete Part B and

issue the Form.

(3) When the prothonotary has issued a Form pursuant to subsection (2), the appellant

must within ten days serve a copy of the issued Form on the head of the public body

referred to in the Form.

(4) An appeal shall be heard in accordance with the Act and the Nova Scotia Civil

Procedure Rules apply with the necessary changes in details.

Notice to Third Parties

13 For the purposes of subsections 22(1) and 31(2) of the Act, it is deemed to be practicable

to give the third party a notice where the third party can reasonably be located.

Section 13 added: O.I.C. 95-591, N.S. Reg. 130/95.

14 Where a third party is a corporation registered to carry on business in the Province, a

notice to the third party pursuant to subsection 22(1) of the Act or a notice of disclosure to

the third party pursuant to subsection 31(3) of the Act shall be given by registered mail

addressed to the last known address of the recognized agent of the corporation or if the

corporation does not have a recognized agent, by registered mail addressed to the last

known address of the corporation.

Section 14 added: O.I.C. 95-591, N.S. Reg. 130/95.

Interpretation of administrative proceeding

15 For the purposes of clause 4(3)(

a) of the Act, “administrative proceeding” includes the

alternative dispute resolution mechanism provided for in the Memorandum of

Understanding Regarding Compensation For Survivors of Institutional Abuse made

effective June 17, 1996, between the Province and the Survivors.

Section 15 added: O.I.C. 96-610, N.S. Reg. 133/96; heading added: O.I.C. 2000-602, N.S. Reg. 193/2000.

Interpretation of terms with respect to local public bodies

16 For the purpose of the Act, “enactment” includes, in the case of a university, any legal

authority pursuant to which the university acts.

Section 16 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

17 For the purpose of clause 4(2)(

d) of the Act, a “person acting in a judicial or quasi-judicial

capacity” includes, in the case of a university,

(

a) a person; or

(

b) a member or a chair of a committee

authorized, under the enactment of the university, to act in a judicial or quasi-judicial

capacity.

Section 17 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

18 For the purpose of clause 4(2)(

e) of the Act, “Ombudsman” includes, in the case of a

university, an officer of the university responsible, under the enactment of the university,

for making inquiries and recommendations respecting complaints against the university.

Section 18 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

19 For the purpose of

Section 19A of the Act, “governing body” includes, in the case of a

university, the faculties and the senate of the university.

Section 19 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

20 For the purpose of subsection 19B(2) of the Act, “employee of the local public body”

includes

(

a) an employee of the employee of the local public body;

(

b) an individual engaged by the employee of the local public body under contract

whether as an independent contractor or otherwise;

(

c) an individual engaged under a contractual arrangement by or with the local

public body;

(

d) a student attending or providing services to a local public body; and

(

e) a visiting professor at the local public body,

and the “employee’s employment” shall be read accordingly.

Section 20 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

21 For the purpose of

Section 19D of the Act, the definition of “hospital” in clause 3(1)(ca) of

the Act is enlarged to include a university, or part of a university, associated with a hospital

for the purpose of medical care.

Section 21 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

Time limit for compliance by public body

22 For the purpose of subsection 38(2) of the Act, the time within which a public body shall

comply with a requirement imposed by the Review Officer pursuant to that subsection,

shall be 15 days from the date of receipt by the public body of notice by the Review

Officer of the requirement.

Section 22 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

Compliance by public body with time limit

23 For greater certainty, where a public body is required pursuant to the Act to provide a

written communication or notification within a prescribed time limit, it is sufficient

compliance with the time limit if the public body deposits the communication or

notification in the postal service within the time limit.

Section 23 added: O.I.C. 2000-602, N.S. Reg. 193/2000.

Definitions of words and expressions with respect to the definition of “background

information”

(1) For the purpose of subclause 3(1)(a)(

i) of the Act, “factual material” means a

coherent body of facts, separate and distinct from

interpretations of, reactions to or

advice and recommendations in respect of facts.

(2) For the purpose of subclause 3(1)(a)(iv) of the Act, “appraisal” means a report

prepared by a qualified appraiser that estimates the value of property or sets a price

on an asset or liability.

(3) For the purpose of subclause 3(1)(a)(

v) of the Act, “economic forecast” means a

prediction of the performance of a national, provincial or local economy over a

specified period of time prepared by an economist.

(4) For the purpose of subclause 3(1)(a)(vi) of the Act, “environmental-impact

statement” means a detailed written statement of an assessment of environmental

effects of a proposed project or activity, as required by law.

(5) For the purpose of subclause 3(1)(a)(vii) of the Act,

(a) “performance” means an action, task or operation, seen in terms of how

successfully it was performed in relation to expected outcomes;

(b) “efficiency” means the quality of achieving maximum productivity with

minimum wasted effort or expense;

(c) “public body” means a public body as it existed on or before the making of the

final report or final audit was begun;

(d) “programs or policies” means programs or policies as they existed on or before

the making of the final report or final audit was begun.

(6) For the purpose of subclause 3(1)(a)(ix) of the Act, “feasibility study” means a study,

the fundamental purpose of which is to advise a public body on the practicability of a

specific proposed project, that includes an evaluation of whether the project, or

specific proposals for that project, are capable of being accomplished with a

reasonable assurance of success and in accordance with established standards

including specified financial limits.

Section 24 added: O.I.C. 2002-427, N.S. Reg. 117/2002.

Definition of expression “officers of the public body”

25 For the purposes of

Section 44 of the Act, “officers of the public body” includes, in the

case of any government department or office, officers of the Department of Internal

Services.

Section 25 added: O.I.C. 2015-102, N.S. Reg. 185/2015.

________________________________________________________________

Form 1—Application for Access to a Record

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 6(1)

TO:

(Address to the Deputy Minister or

senior administrative officer of the

public body where the record is filed or

deposited.)

1. This is an application pursuant to the Freedom of Information and Protection of Privacy

Act for access to:

Check one

_____ (

a) applicant’s own personal information; or

_____ (

b) other information; or

_____ (

c) both applicant’s own personal information and other information.

2. I am applying for access to the following record:

(Below, identify the material applied for precisely by including such particulars as the

specific event or action to which it refers, the date of the record or the date or period to

which it relates, the type of record (document, report, letter et cetera), names of

department personnel who prepared or may have knowledge of the information, or

citations to newspapers or publications which are known to have referred to the record.)

3. I wish to:

Check one

_____ (

a) examine the record; or

_____ (

b) receive a copy of the record.

4. I understand that I may be required to pay a fee before obtaining access to the record.

Date: ________________

Signature of Applicant:

Print Full Name of Applicant:

Mailing Address of Applicant:

(Street/Apartment No./R.R. No.)

(Community/County)

(Postal Code)

Telephone Numbers of Applicant:

(Residence) (Business)

Fax Number of Applicant:

Request to Waive Fees

I hereby request to be excused from paying fees related to the above application because:

(a)I cannot afford to pay fees; or

(b) (specify any other reason)

For office use only

Date Received

Application No.

________________________________________________________________

Form 2—Request for Correction of Personal Information

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 25(1)

TO:

(Address to the Deputy Minister or

senior administrative officer of the

public body where the information is

filed or deposited.)

1. This is a request pursuant to the Freedom of Information and Protection of Privacy Act for

correction of personal information.

2. The details of the personal information requested to be corrected are as follows:

(

a) last name appearing on personal information to be corrected: ;

(

b) department or institution maintaining personal information: ;

(

c) name of personal information bank or record: ;

(

d) description of personal information to be corrected:

3. The correction requested is as follows:

Date: _____________________

Signature of Requester:

Print Full Name of Requester:

Mailing Address of Requester:

(Street/Apartment No./R.R. No.)

(Community/County)

(Postal Code)

Telephone Numbers of Requester:

(Residence) (Business)

Fax Number of Requester:

For office use only

Date Received

Request No.

________________________________________________________________

Form 3—Consent to Disclosure of Information

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 21(4) and Clause 27(

b) TO:

(Address to the Deputy Minister or senior

administrative officer of the public body

where the information is filed or

deposited.)

1. This Consent arises out of an Application for Access to Records submitted to the

__________ (specify public body) on the _______ day of __________, 19___,

for information relating to ______________________________, a copy of which

Application is attached as

Schedule “A” to this Consent.

2. I, _________________ (specify name of person consenting) , hereby give consent to the

_________________ (specify name of public body) and the head thereof to disclose to

__________________ (specify name of applicant) information listed in

Schedule “B”

attached to this Consent. (List in

Schedule “B” in detail full particulars of information

with respect to which consent to disclose is given.)

Date: ____________________

Signature of Person Consenting:

Print Full Name of Person Consenting:

Mailing Address of Person Consenting:

(Street/Apartment No./R.R. No.)

(Community/County)

(Postal Code)

Telephone Numbers of Person Consenting:

(Residence) (Business)

Fax Number of Person Consenting:

________________________________________________________________

Form 4—Consent to use of Personal Information

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Clause 26(

b) TO:

(Address to Deputy Minister or senior

administrative officer of the public body

requesting consent.)

1. I, ________________ (name of consenting individual) , of _______________

_____________ (address) , do hereby give consent to the _________________ (name of

public body) and the head thereof to disclose to _________________ (name of person or

body) , of _______________ (address), the following information about me

(if insufficient space, list additional information on separate page) ; and

(

b) to use the information for the following purposes:

Date: ___________________

Signature of Consenting Individual:

Print Full Name of Consenting Individual:

Mailing Address of Consenting Individual:

(Street/Apartment No./R.R. No.)

(Community/County)

(Postal Code)

Telephone Numbers of Consenting Individual:

(Residence) (Business)

Fax number of Consenting Individual:

________________________________________________________________

Form 5—Agreement

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Clause 29(

d) This agreement is made between ________________ (name of researcher) , referred to below

as the researcher, and ___________________ (name of public body) , referred to below as the

public body.

The researcher has requested access to the following records that contain personal information

and are in the custody or under the control of the public body: (Describe the records below)

1. The researcher will not use the information in the records for any purpose other than the

following research purpose unless the researcher has the public body’s written

authorization to do so: (Describe the research purpose below)

2. The researcher will give access to personal information in a form in which the individual

to whom it relates can be identified only to the following persons: (Name the persons

below)

3. Before disclosing personal information to persons mentioned above, the researcher will

enter into an agreement with those persons to ensure that they will not disclose it to any

other person.

4. The researcher will keep the information in a physically secure location to which access is

given only to the researcher and to the persons mentioned above.

5. The researcher will destroy all individual identifiers in the information by ________ (date) .

6. The researcher will not contact any individual to whom personal information relates,

directly or indirectly, without the prior written authority of the public body.

7. The researcher will ensure that no personal information will be used or disclosed in a form

in which the individual to whom it relates can be identified without the written authority of

the public body.

8. The researcher will notify the public body in writing immediately upon becoming aware

that any of the conditions set out in this agreement have been breached.

Signed at ___________, _________ this ______ day of _________, 19___.

Researcher Representative of Public Body

Signature: Name:

Print Full Name: Position:

Mailing Address: Public Body:

(Street/Apartment No./R.R. No.) Address:

(Community/County)

Telephone Number:

(Postal Code) Fax Number:

Telephone Numbers:

(Residence)

(Business)

Fax Number:

________________________________________________________________

Form 6—Notice of Disclosure

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 31(3)

TO:

(Specify name and last known

address of Third Party.)

TAKE NOTICE that on the ___ day of __________, 19___, I,________________ _________

(name of head) , head of ____________________ (name of public body) , _________________

(address of public body) , disclosed to ___________________________ (specify the public,

affected group of people or applicant) certain information relating to you and which is

described in

Schedule “A” attached to this Notice of Disclosure.

It was not practicable to notify you before disclosing the information.

The information disclosed was:

Check if applicable

_____ (

a) about a risk of significant harm to the environment;

_____ (

b) about a risk of significant harm to the health or safety of the public;

_____ (

c) about a risk of significant harm to (specify affected group of people)

_____ (

d) disclosed in the public interest because (state any other public interest reason

for disclosure)

Dated at __________, Nova Scotia, this _____ day of _______, 19___.

Signature of Head of Public Body

Schedule “A”

Particulars of the information disclosed are as follows:

________________________________________________________________

Form 7—Request for Review

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 32(1)

(Applicant)

TO: Review Officer

(Specify name and address of

Review Officer.)

1. This Request for Review arises out of an Application for Access to a Record or Request

for Correction of Personal Information submitted to _______________ (specify public

body) on the ____ day of ___________, 19___, a copy of which Application or Request is

attached to this Request for Review.

2. The applicant requests that the review officer review the following decision, act or failure

to act of the head of the public body;

Check where applicable

(

a) decision dated or made on the _____ day of ________, 19___, a

copy of which is attached to this Request for Review;

(b) (specify act or failure to act)

3. The applicant requests that the review officer recommend that

Check where applicable

(

a) the head of the public body give access to the record as requested in

the Application for Access to a Record;

(

b) the head of the public body correct the personal information as

requested in the Request for Correction of Personal Information;

(b) (c) (specify other recommendation or recommendations, if any, you

consider appropriate)

Date: _______________________

Signature of Applicant:

Print Full Name of Applicant:

Mailing Address of Applicant:

(Street/Apartment No./R.R. No.)

(Community/County)

(Postal Code)

Telephone Numbers of Applicant:

(Residence) (Business)

Fax Number of Applicant:

________________________________________________________________

Form 8—Request for Review

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 32(2)

(Third Party)

TO: Review Officer

(Specify name and address

of Review Officer.)

1. This Request for Review arises out of an Application for Access to a Record submitted to

_______________ (specify public body) on the _________ day of __________, 19___,

and a decision of the head of the public body to give access to the record or part of the

record, which decision is contained in a written notice given by the head of the public body

pursuant to subsection 23(2) of the Act.

2. A copy of the written notice and decision of the head of the public body are attached to

this Request for Review.

3. The Third Party requests that the review officer recommend that the head of the public

body not give access to any part of the records requested in the Application for Access to a

Record that contains information the disclosure of which may affect the interests or invade

the personal privacy of the Third Party.

Date: ___________________

Signature of Third Party:

Print Full Name of Third Party:

Mailing Address of Third Party:

(Street/Apartment No./R.R. No.)

(Community/County)

(Postal Code)

Telephone Numbers of Third Party:

(Residence) (Business)

Fax Number of Third Party:

________________________________________________________________

Form 9—Appeal

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 32(3)

IN THE SUPREME COURT OF NOVA SCOTIA

and

IN THE MATTER OF AN APPEAL PURSUANT TO

SECTION 41 OF THE

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT,

S.N.S. 1993, c. 5

TO: The Prothonotary of the Supreme Court of Nova Scotia

1. The Appellant’s name and address are:

2. This Appeal arises out of an Application for Access to a Record or Request for Correction

of Personal Information submitted to _______________________ (specify public body) on

the ______ day of ____________, 19___, a copy of which Application or Request is

attached as Appendix 1 to this Appeal.

3. The Appellant appeals the following decision, act or failure to act of the head of the public

body relating to the attached Application or attached Request:

Check where applicable

(

a) decision dated or made on the ____ day of _______, 19___, a copy

of which is attached as Appendix 2 to this Appeal;

(b) (specify any act or failure to act)

4. Check where applicable

(

a) no third party has been notified pursuant to

Section 22 of the

Freedom of Information and Protection of Privacy Act ; or

(

b) any third party notified pursuant to

Section 22 of the Freedom of

Information and Protection of Privacy Act has consented to this

Appeal, a copy of which Consent is attached as Appendix 3 to this

Appeal.

5. No person has filed a Request for Review in relation to the attached Application or

attached Request.

6. The Appellant hereby requests that the head of the public body be ordered

Check where applicable

(

a) to give the Appellant access to the records requested in Appendix 1;

(

b) to correct the personal information as requested in Appendix 1;

(b) (c) (specify other order sought, if any, relating to any decision, act or

failure to act of the head of the public body that relates to the

attached Application or attached Request)

Dated at , Nova Scotia, this day of , 19 .

Signature of Appellant

Part B

Notice of Appeal

Let the Appellant and __________________ attend before this Honourable Court at

__________ on the _____ day of ___________, 19___ at the hour of _____ o’clock in the ____

noon on the hearing of the above Appeal.

Dated at _________, Nova Scotia, this _____ day of __________, 19___.

Prothonotary

________________________________________________________________

Form 10—Appeal

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 41(1)

IN THE SUPREME COURT OF NOVA SCOTIA

and

IN THE MATTER OF AN APPEAL PURSUANT TO

SECTION 41 OF THE

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT,

S.N.S. 1993, c. 5

TO: The Prothonotary of the Supreme Court of Nova Scotia

Part A

Statement of Facts

1. The Appellant’s name and address are:

2. This Appeal arises out of an Application for Access to a Record or Request for Correction

of Personal Information submitted to ___________________ (specify public body) on the

____ day of ____________, 19___, a copy of which Application or Request is attached as

Appendix 1 to this Appeal.

3. A Request for Review was filed with a review officer on the __ day of ________, 19_, a

copy of which Request for Review is attached as Appendix 2 to this Appeal.

4. The review officer conducted a review and prepared a report setting out the review

officer’s recommendations with respect to the matter and the reasons for those

recommendations, a copy of which report is attached as Appendix 3 to this Appeal.

5. The head of the public body made a decision dated the ____ day of _______, 19___, a

copy of which decision is attached as Appendix 4 to this Appeal.

The head of the public body did not give written notice of a decision within the time

required by subsection 40(1) of the Freedom of Information and Protection of Privacy Act .

6. The Appellant appeals the decision of the head of the public body.

7. The Appellant hereby requests that the head of the public body be ordered

Check where applicable

(

a) to give the Appellant access to the records requested in Appendix 1;

(

b) to correct the personal information as requested in Appendix 1;

(b) (c) (specify other order sought, if any, relating to any decision, act or

failure to act of the head of the public body that relates to the

Application or Request attached as Appendix 1 to this Appeal)

Dated at __________, Nova Scotia, this ______ day of _________, 19___.

Signature of Appellant

Part B

Notice of Appeal

Let the Appellant and ___________________________________ attend before this

Honourable Court at ___________ on the _____ day of ___________, 19___ at the hour of

_____ o’clock in the ____ noon on the hearing of the above Appeal.

Dated at __________, Nova Scotia, this _____ day of ___________, 19___.

Prothonotary

________________________________________________________________

Form 11—Appeal

Province of Nova Scotia

Freedom of Information and Protection of Privacy Act

Subsection 41(1)

IN THE SUPREME COURT OF NOVA SCOTIA

and

IN THE MATTER OF AN APPEAL PURSUANT TO

SECTION 41 OF THE

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT,

S.N.S. 1993, c. 5

TO: The Prothonotary of the Supreme Court of Nova Scotia

Part A

Statement of Facts

1. The Appellant’s name and address are:

2. This appeal arises out of an Application for Access to a Record submitted to

______________ (specify public body) on the ______ day of __________,19___, a copy

of which Application is attached as Appendix 1 to this Appeal.

3. The Appellant was notified pursuant to

Section 22 of the Freedom of Information and

Protection of Privacy Act, a copy of which notification is attached as Appendix 2 to this

Appeal.

4. A Request for Review was filed with a review officer on the _____ day of _______,

19___, a copy of which Request for Review is attached as Appendix 3 to this Appeal.

4. [5.] The review officer conducted a review and prepared a report setting out the review

officer’s recommendations with respect to the matter and the reasons for those

recommendations, a copy of which report is attached as Appendix 4 to this Appeal.

5. [6.] The head of the public body made a decision dated the ______ day of _________,

19___, a copy of which is attached as Appendix 5 to this Appeal.

The head of the public body did not give written notice of a decision within the time

required by subsection 40(1) of the Freedom of Information and Protection of Privacy

Act.

6. [7.] The Appellant appeals the decision of the head of the public body.

7. [8.] The Appellant hereby requests that the head of the public body be ordered

Check where applicable

(

a) not to give the applicant access to any part of the records requested in

Appendix 1 that contains information the disclosure of which may affect

the interests or invade the personal privacy of the Appellant;

(b) (specify other order sought, if any, respecting any decision made by the

head of the public body about the Application attached as Appendix 1 to

this Appeal)

Dated at ________, Nova Scotia, this _____ day of ________, 19___.

Signature of Appellant

Part B

Notice of Appeal

Let the Appellant and _____________________ attend before this Honourable Court at

_________ on the ______ day of __________, 19___ at the hour of ____ o’clock in the ____

noon on the hearing of the above Appeal.

Dated at ________, Nova Scotia, this ____ day of _________, 19__.

Prothonotary