Required fields are marked with asterisks (*)

By-Law Complaint Form

If you wish to lodge a complaint, you may write your own letter or use this form. Please complete as many areas as you can and provide as much detail and information as possible. You must provide full contact information including your full name, address, including P.O. Box is required, and telephone number where you can be reached during regular office hours.

All complaints will be received courteously, investigated and acted upon fairly. You should be aware that while the Municipality of Brockton makes every effort to assure privacy of the complainant, you may be required to present evidence in support of this complaint at any hearings of Appeals Committee or Court of Law of Ontario.

Last Name:

First Name:

Your Address

Street Name:

P.O. Box (If Applicable)

Town/City:

Postal Code:

Province:

Your Contact Information

Contact Telephone Number:

Email Address:

Complaints Lodged Against/Location of Complaint:

Address of Complaint:

Name of individual/business the complaint is regarding:

Date of Offence:

Time (If applicable):

Nature of Complaint:

Statement of Complainant:

I hereby make this statement of complaint believing it to be true and for no improper or vexatious purpose. I hereby further declare that if required, I will provide or present evidence in support of this complaint at any hearings of Appeals Committee or Court of Law of Ontario.

Date:

Signature of Complainant:

Clear

All complaints will be verified to ensure legitimacy and providing false information may lead to the dismissal of the complaint.

Personal Information contained on this form is collected under the authority of the Municipal Act, 2001 for the purpose of responding to and tracking complaints. This information will be kept confidential.