Government of Ontario

Fire Safety Commission
Safety, Licensing Appeals and
Standards Tribunals Ontario

PO Box 250
Toronto ON  M7A 1N3
Telephone: 416-327-6500
Fax: 416-314-4270

Declaration of Representative

Important Information

1. Representative Information


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 416-327-6500 or toll-free at 1-844-242-0608.

0430E (2019/07)       © Queen’s Printer for Ontario, 2019

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