Access to BIA Membership Information

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In accordance with Section 2.06 of City Procedure, "Access to Information for Business Improvement Areas" in City Policy C462B, the person who is submitting this form is requesting access to BIA membership information.

1. Please select the Business Improvement Area that you are representing. *

2.Please specify what information you are requesting. (check all that apply) *

Tax Roll Account Identification for each business

Business Name for each business

Business Address for each business

Annual Business Assessment for each business

Annual BIA tax (levy) for each business

North American Industry Code (NAIC) for each business

Business Contact Info for each business which has consented to it being shared

Other:

Required

3. Please specify the intended use of the information. *

4. Please provide your name, phone number, and email address so that we will be able to share the information back with you if available (Full Name, 780000000, email@email.com). The email address you provide should be the one used regularly in communications with the City as this is what we'll be using it to verify your identity. *

I have read and accept the requirements for use and disclosure of this info in accordance with pages 15 and 16 in City Procedure C462B "Access to Information for Business Revitalization Zones" (https://www.edmonton.ca/business_economy/documents/PoliciesDirectives/C462B.pdf).

Required

I acknowledge and agree that membership data cannot be distributed by the BIA Boards or Executive Directors to third parties for any purpose.

Required

Personal information provided by you on this form is being collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act. It will be used by the City of Edmonton for the purpose of providing your BIA with information for the provision of services related to the operations of the BIA. If you have any questions about the collection, please contact Charles Gordon at 780-944-0300, or by email at charles.gordon@edmonton.ca .

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