Government of Ontario

Tribunals Ontario
Licence Appeal Tribunal

PO Box 250
Toronto ON  M7A 1N3
Phone: 416-327-6500
Toll Free: 1-844-242-0608
Fax: 416-325-1060
Toll Free: 1-844-618-2566
Website: www.slasto-tsapno.gov.on.ca/lat-tamp/en/

Application for Removal of Conditions from a Liquor Licence
under Subsection 14 (2) of the Liquor Licence Act

Important Information

• The Tribunal can only consider requests as set out in subsection 14(2) of the Liquor Licence Act. Requests outside of the parameters of subsection 14(2) cannot be considered.
• You must complete all sections of this form and attach additional information and/or documents as required. This is written process and you must include all documents you wish the Tribunal to consider.
• The processing of your application could be delayed if information or documents are missing.
• There is a non-refundable fee of $106 to file this request.
• You have the right to a representative. If you have a representative, have them complete the Tribunal's ' Declaration of Representative' form and attach it to this form.

Acknowledgment

Read the following carefully, check each box to confirm the statement, then sign and date the form.

I have completed all pages of this form and attached all the required documentation, including a copy this establishment's current liquor licence. I understand that if I submit an incomplete form or do not attach required documents, my application may not be processed.

I have completed the 'Payment Information' section on page 3 of this form and am submitting payment for my application in an acceptable format. (Do not serve a copy of the 'Payment Information' section with your disclosure documents to the Registrar of Alcohol and Gaming. Your payment information should only be provided to the Licence Appeal Tribunal.)

I have served a copy of this form and all additional attached documents to the Registrar of the Alcohol and Gaming Commission of Ontario. I have attached a completed 'Certificate of Service' to this form as proof of service of the documents on the Registrar. (Blank 'Certificate of Service' forms are available on the Tribunal's website at www.slasto-tsapno.gov.on.ca/lat-tamp/en/)

Print Name
Signature

Date (yyyy/mm/dd)

The Licence Appeal Tribunal collects the personal information requested on this form under section 3 of the Licence Appeal Tribunal Act, 1999. This information will be used to determine applications under this Act. After an application is filed, all information may become available to the public. Any questions about this collection may be directed to the Licence Appeal Tribunal at 416-327-6500 or toll-free at 1-844-242-0608.

This page is not part of your disclosure to the other parties. Submit this page to the Tribunal only.

Payment Information:

• Payment of $106 must be submitted with this form in one of the acceptable formats below.
• The filing fee is per licence. If you are filing an application about more than one licence, ensure you have submitted payment for each one.
• Money Orders, Bank Drafts and Certified Cheques must be made payable to the Minister of Finance.

Acceptable Methods of Payment:

I am paying my $106 filing fee by:
Certified Cheque
Money Order
Bank Draft
Credit Card*

* If you are paying by credit card, you must provide the following information:
MasterCard
Visa
Expiry Date (mm/yyyy)
Credit Card Number
Cardholder Name (as it appears on card)
Signature

For Licence Appeal Tribunal Office Use Only:
LAT File No.
Date Application and Fee Processed

The Licence Appeal Tribunal collects the personal information requested on this form under section 3 of the Licence Appeal Tribunal Act, 1999. This information will be used to determine applications under this Act. After an application is filed, all information may become available to the public. Any questions about this collection may be directed to the Licence Appeal Tribunal at 416-327-6500 or toll-free at 1-844-242-0608.