Application for Consent to Prosecute

A [PDF Format, 164Kb] of this form is also available.

I. Applicant

Name:

Address:

Telephone Number:

Facsimile Number:

II. Respondent

Name and address of the person or association against whom the prosecution is to be brought:

Name:

Address:

Telephone Number:

Facsimile Number:

III. Particulars of the Respondent's Actions

What section(s) of the Status of the Artist Act is the respondent alleged to have contravened or with which order of the Tribunal is the respondent alleged to have failed to comply?

Provide a full description of the events, circumstances and/or actions taken by the respondent which it is alleged contravene or fail to comply with the Act or the Tribunal order (use additional sheets if necessary):

I hereby certify that the facts set out in this application are true to the best of my knowledge.

Signature of Applicant or Authorized Representative

Date:

Name and address of Applicant's Authorized Representative, if any:

Form 10 (02/2006)

Send Completed Form To:
Canadian Artists and Producers Professional
Relations Tribunal
240 Sparks Street, 1st Floor West
Ottawa, Ontario  K1A 1A1