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/

Notice of Appeal – Motor Vehicle Impoundment

Under s. 55.1 and s. 50.2 of the Highway Traffic Act – Impoundment:
Vehicle driven by driver with a suspended licence

Important Information

This appeal form applies only to appeals of a 45, 90 or 180 day impoundment of a vehicle under s. 55.1 of the Highway Traffic Act. Please include a copy of the Notice of Motor Vehicle Impoundment.
You must complete all sections of this form and attach additional information and/or documents as required.
The processing of your appeal could be delayed if information or documents are missing.
There is a non-refundable fee of $106 to file this appeal.
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.

Name of Owner of Impounded Vehicle and Contact Information:

Last Name
First Name
Middle Initial

Company Operating Name (if applicable)
Numbered Company Name (if applicable)

Address

Unit No.
Street No.
Street Name
City
Province
Postal Code
Telephone No.
Fax No.

Impounded Vehicle Information:

Vehicle Identification Number (VIN)
Year
Make
Model
Commercial Vehicle Operator's Registration Number of Impounded Vehicle
Plate Number

Incident Information:

Name of Impoundment Facility
Address
Impoundment Order Number
Date Impoundment Order was issued (dd/mm/yyyy)

Name of the Driver at the Time of Impoundment:

Last Name
First Name
Middle Initial

Number of days vehicle is ordered to be impounded (select one):

45 days
90 days
180 days

Grounds For Appeal (The only grounds on which an owner may appeal, and the only grounds on which the Tribunal may order the Registrar to release the motor vehicle are):

that the motor vehicle that is impounded was stolen at the time it was detained in order to be impounded;
that the driver's licence of the driver of the motor vehicle at the time it was detained in order to be impounded was not then under suspension;
that the owner of the motor vehicle exercised due diligence in attempting to determine that the driver's licence of the driver of the motor vehicle at the time it was detained in order to be impounded was not then under suspension; or
that the impoundment will result in exceptional hardship.

I am filing my appeal within 15 days after the day the vehicle was detained:

Yes
No

Reasons for Appeal

Describe in detail the reasons for your appeal and state how the reasons relate to the ground(s) for appeal. (Attach additional pages if you need more space.)

Acknowledgement

Read carefully then check each box to confirm the statement and sign and date the form.
I have completed all pages of this form and attached all the required documentation. I understand that if I submit an incomplete form or do not attach required documents, my appeal may not be processed.
I have completed the 'Payment Information' section on page 4 of this form and am submitting payment for my appeal in an acceptable format.

Print Name
Signature

Date (yyyy/mm/dd)

The following section 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 appeal 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:**
If you are filing your appeal...	You must pay by...
by fax	credit card
by mail or courier	credit card certified cheque money order bank draft

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

The information you provide on this sheet is confidential. It will be used to process your application, but will not be placed on your file.

For Licence Appeal Tribunal Office Use Only:

LAT File No.
Date Appeal 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 appeals under this Act. After an appeal 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.

Disponible en français