Notice of Complaint

A PDF version of this form is also available.

I. Complainant

Name:

Address:

Telephone Number:

Facsimile Number:

II. Respondent

Name of the person(s) or organization(s) against whom the complaint is being made:

Address:

Telephone Number:

Facsimile Number:

III. Details of the Complaint

Give a factual description of the events which form the basis for the complaint (use additional sheets if necessary):

What provision(s) of the Status of the Artist Act do you feel have been contravened?

______ section 32(a) ______ section 32(b) ______ section 35

______ section 50 - specify subsection(s):

______ section 51 - specify subsection(s):

______ section 52

On what date did you first know of the actions or the circumstances forming the basis for the complaint?

IV. Resolution Sought

What steps have already been taken to try to resolve this complaint? (use additional sheets if necessary):

In your opinion, what would be the best resolution of this complaint (i.e. what corrective action do you feel is required)?(use additional sheets if necessary):

V. Language of Choice for Tribunal Proceedings

______ English ______ French ______ Bilingual

I hereby certify that the facts set out in this complaint are true to the best of my knowledge.

Signature of Complainant: _______________________

Date: ________________

Please indicate the name and address of any other person to whom copies of correspondence concerning this complaint should be sent (eg. the complainant's authorized representative, if any)

Form 3 (02/2006)

Send Completed Form To:
Canadian Artists and Producers Professional
Relations Tribunal
240 Sparks Street, 1st Floor West
Ottawa, Ontario  K1A 1A1