Government of 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 Withdrawal

Important Information

Notice of Withdrawal:

In the matter of Licence Appeal Tribunal file number

I, the Appellant


withdraw my appeal before the Tribunal. I understand that, by withdrawing my appeal, my file will be closed and my rights to a hearing before the Tribunal in this matter will be terminated.

Copy to Respondent:

I have sent a copy of this Notice of Withdrawal to the Respondent, or their representative,

By the following method:

        

at the following facsimile No. / address

Address Notice of Withdrawal was delivered to:







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