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Collection of Information: Personal information contained on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25 and will be used for the purposes of administering your request for, and use of, Boards and Committees Application. Questions about this collection should be directed to the Clerk, 312915 Dereham Line, Mt. Elgin, ON, N0J 1N0