Licence Appeal Tribunal
15 Grosvenor Street, Ground Floor, Toronto ON   M7A 1N3 Telephone: 416-326-1356 Toll Free: 1-888-444-0240 TTY: 1-800-855-0511 Website: https://tribunalsontario.ca/lat/
Important Information
Case Conference Hearing Motion Licence Appeal Tribunal file No. Date (yyyy/mm/dd) Time including AM/PM (hh:mm)
Reason for this Request to Adjourn:
Consent to the adjournment * Do not consent to the adjournment
* If all parties consent to this adjournment, provide three dates within the next 30 days that all parties are available to attend. If all parties do not consent, provide three dates in the next 30 days, you the requestor are available to attend.
1. Date (yyyy/mm/dd) 2. Date (yyyy/mm/dd) 3. Date (yyyy/mm/dd)
Applicant Respondent Added Party Last Name First Name Signature Date (yyyy/mm/dd)
Important: For matters with multiple parties, attach any additional signatures on a separate page.
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 416-326-1356 or toll-free at 1-888-444-0240.