Complaint Form

Required fields are marked with asterisks (*)

Confidential

This form represents a request to resolve an alleged by-law infraction within the Township of Wainfleet. In order for the By-law Enforcement Officer to proceed with an investigation, it is mandatory that you provide your full name, current address, and phone number along with your signature.

*Anonymous complaints will not be accepted. Please do not trespass on any property to confirm a complaint.

Complainant Information (Your Information):

Name:

Email Address:

Phone Number:

Street Address:

Unit #:

City/Town:

Province:

Postal Code:

Same mailing address?

Yes

Mailing Address:

Street Address:

City/Town:

Province:

Postal Code:

Violation Information (Property/Person you are Making a Complaint About):

Location of Offence (Street Address)

Name of Property Owner/Tenant (If Known):

Nature of Complaint (Be Specific as to What Violations are Taking Place):

You may upload relevant images or files.

Confidentiality will be maintained between the complainant and alleged offender, except where disclosure is necessary in a Court of Law or when subject to the provisions of the Freedom of Information and Protection of Privacy Act noted below. Should this complaint proceed to Court, you may be required to give evidence as a witness, and your name and filed complaint will become a matter of public record.

Disclaimer: The personal information requested on this form is being collected for the purpose of conducting a By-law Enforcement investigation and may be shared with applicable departments and agencies for the purpose of initiating appropriate action. Collection of personal information is governed, authorized, and protected by the Freedom of Information and Protection of Privacy Act. By providing this information, you consent to its use for the above purposes.

I hereby swear that the above information is true and correct to the best of my knowledge.

I would like a copy of this complaint for my records.

Yes

Please enter the email you would like your response sent to:

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