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Get Canada P-612 09 05 26

On Requests and Fees), to: Winnipeg Police Service, P.O. Box 1680, Winnipeg, Manitoba R3C 2Z7 Attention: Bureau of Police Records SECTION 1 - Identification of the Applicant (When completing this section, please write all names in full – NO INITIALS) Surname (Last/Family Name) First Name Middle Name Male Female Other Names Used: (maiden, birth, etc.) Date of Birth: Birth Place: (YEAR, MONTH, DAY) (PROVINCE OR COUNTRY) Address: City: Postal Code: Home Phone Number: Identification .

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