Personal information contained on this form is collected under the authority of the Municipal Act, 2001, c.25, as amended and will be used, maintained and disclosed in accordance with the Municipal Freedom of Information and Protection of Privacy Act c. M56 s.29(2) for the purpose of donating and/or requesting an engraved seat dedication plaque on a Town of Huntsville facility seat. Contact the Municipal Clerk, 37 Main Street East, Huntsville ON P1H 1A1, (705) 789-1751, clerk@huntsville.ca for information regarding the collection and disclosure of information.