Government of Ontario

Tribunals Ontario
Animal Care Review Board

Declaration of Representative

Important Information

1. Representative Information






Address









2. Declaration of Representative


Before the Animal Care Review Board in the matter of (Name of Appellant)



And (Name of Respondent)



3. Acknowledgement







The Animal Care Review Board (ACRB) collects the personal information requested on this form under section 38 of the Provincial Animal Welfare Services Act and section 9(5) of Ontario Regulation 443/19 for the purpose of conducting an appeal proceeding before the ACRB. All information, including sensitive personal and financial information, submitted as part of a proceeding may become public in an open hearing and may be contained in decisions, orders, and case files, unless an order to restrict access is made. Any questions about the collection of information may be directed to the ACRB at acrb.registrar@ontario.ca.

If you have any questions, please contact

Animal Care Review Board
PO Box 250
Toronto ON  M7A 1N3
Telephone:   416-327-6500
                     1-888-444-0240
Fax:              416-314-4270
                     1-800-720-5292
Website: www.slasto.gov.on.ca
Email: acrb.registrar@ontario.ca

0427E (2020/06)       © Queen’s Printer for Ontario, 2020

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