Instructions:
1. To appeal an Order of Administrative Penalty imposed under the Payday Loans Act, 2008, you must complete and file this form, together with a copy of the Order imposed. The Notice of Appeal must be filed by serving it personally or delivering it by registered mail to the Ministry of Consumer Services, Policy and Comsumer Protection Services Division, Administrative Penalties, 777 Bay Street, 5th Floor, Toronto ON M7A 2J3. If you file a Notice of Appeal, you do not have to pay the penalty until the appeal is decided.
2. The Notice of Appeal must be filed within 15 days after you recieve the Order imposing the Administrative Penalty.
3. You may provide written submissions to support your appeal. Written submissions must be filed by serving them personally or delivering them by registered mail to the address set out above. Written submissions must be filed within 30 days after you revieve the Order imposing the Administrative Penality.
4. If you have attached written submissions to this Notice of Appeal, check the box:
5. If you forward written submissions separate from this Notice of Appeal, attach a copy of the Order imposing the Administrative Penalty.
Contact Information
Legal Name Address for Service Licence No. (for payday lender or payday loan broker) Location of Contravention (insert address)
Reasons for Appeal
Signature Name Title Date (yyyy/mm/dd)