E. Fees , A requestfor access to a record, other than a record containingpersonal (4) information aboutyourself; will be processed only after a requestfee has been paid (b) You will be notified of the amount requiredto be paid czs the requestfee. (c) Thefee payablefor access to a record depend$on the form in which access is required andthe reasonable time requiredto searchfor and prepare a record. Ifyou qual@ for exemption of the payment of my fee, pIease state the reason (d) therefor. -__ fees: payment ofexemption fromfor Reason - ~ . - Form of access to record F. you are prevented by a disabilityto read, view or listen to the record in the form of access IIpr ovided for in 1 to 4 hereunder, state your disabilityand indicate in which form the record is j required. lisabiiity: r- Form in .which record is required: Mark the appropriate box with an “X”. NCTES: (a) Your indication as to the required form of acces:; dependson the form in which the recordis available. (b) Access in the form requested may be refused in certain circumstances. In such a caseyou will be informedif access will be granted in anotherf o m (c) Thefee payable for access to the record, if any, will be determinedpartly by the form in which access is mquested

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