Request for Fire Incident Report

Township of Selwyn

Request for Fire Incident Report

Name of requestor (firm name - name of individual)

Mailing address (number and street - city - province - postal code)

Phone number:

Email:

How would you like to receive your response?

Email only

Email and mail

Your file number:

Date required:

If you do not know the roll number, please use our VTH Property Search.

Roll number:

Property address/Incident location:

Legal description:

Present owner:

The cost of this request is

How would you like to pay for this request?

Cheque - payable to Township of Selwyn (mailed to PO Box 270, Bridgenorth ON K0L 1H0 or courier to 1310 Centre Line, Selwyn ON K9J 6X5)

Online - debit or credit: instructions and notification to sign into your Virtual Town Hall (VTH) account will be sent to the email address that you have provided.

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