This form may contain personal information as defined under the Municipal Freedom of Information and Protection of Privacy Act. This information is collected under the legal authority of the Municipal Act, 2001, S.O. 2001 c.25, as amended. This information will be used and maintained by the Township of Southwold to process the request for a memorial bench. Questions regarding this collection may be directed to the CAO/Clerk, 35663 Fingal Line, Fingal ON N0L 1K0, 519-769-2010 or by email to cao@southwold.ca.