If fees are applicable, you will be redirected to our online payment page to submit your payment.
If your payment submission is successful, you will receive an email confirming your successful submission of your appeal with a PDF copy of your receipt attached.
If fees are not applicable, you will receive an email confirming your successful submission of your appeal.
Information about the Appeal Process
For more information about the processes of the Information and Privacy Commissioner of Ontario (IPC) and the
Code of Procedure for appeals, please contact our office at:
List of Attachments:
I certify that the information submitted in this appeal is true and correct to the best of my knowledge.
Unable to Proceed:
You must agree to the Declaration on the previous page to submit this form online.
Note: To make changes to the information below, please click the “Back” button (at the bottom of this page) to access previous pages or “Edit Section” to make corrections.
Name of Company, Association or Organization:
Name (First Name, Initials, Last Name/Single Name):
Alternate Telephone Number:
Representative is a:
Name (First Name, Initials, Last Name):
The following documents have been attached:
Name of Institution:
Institution File Number:
Details of the Appeal
(Selections that explain why the appeal is being made)
Resolution of Appeal
(Please describe how you feel this appeal could be resolved)
(Please list any previous, or ongoing appeals you have with the Office of the Information and Privacy Commissioner of Ontario)
I have read and agree to the Declaration.
I acknowledge and agree that: (a) my appeal will be processed in accordance with the IPC’s Code of Procedure and Practice Directions for appeals under FIPPA and MFIPPA; and (b) I will cooperate fully with the IPC and provide responses to the IPC in accordance with any instructions or deadlines communicated to me.
Consent to provide a copy of documentation to the institution:
Name (First and Last Name):
We accept Visa, Visa Debit, Mastercard, Debit Mastercard and Interac® Online.
Thank you for your Submission.
You will receive an email confirmation which contains a confirmation number for your records.
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