Government of Ontario

Tribunals Ontario
Fire Safety Commission

15 Grosvenor St, Ground Fl
Toronto ON  M7A 2G6
Telephone: 416-326-1356 / 1-888-777-3616
Teletypewriter (TTY): 1-800-855-0511
Fax: 416-314-4270 / 1-800-720-5292
Website: tribunalsontario.ca/fsc
Email: FSCregistrar@ontario.ca

Declaration of Representative

Important Information

1. Representative Information






Address









2. Declaration of Representative


Before the Fire Safety Commission in the matter of (Name of Appellant)




And (Name of Respondent)



3. Acknowledgement







The Fire Safety Commission collects the personal information requested on this form under sections 26, 33, and 36 of the Fire Protection and Prevention Act, 1997. This information is being collected for the purpose of conducting a proceeding before the FSC. Any questions about this collection may be directed to the Fire Safety Commission at 416-326-1356 or toll-free at 1-888-777-3616 or teletypewriter (TTY) at 1-800-855-0511.

0430E (2022/11)       © King’s Printer for Ontario, 2022

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