TAKE NOTICE that the Appellant appeals against the decision of a Human Rights Tribunal pronounced the day of , 19.
The Appellant proposes that this appeal be heard at in the Province of .
The Appellant’s address for service is .
The Appellant appeals on the following grounds (a brief statement of the points to be argued).
DATED at , the day of , 19.
Human Rights Tribunal Panel
- SOR/86-294, s. 3
- SOR/90-286, s. 4
- SOR/94-237, s. 1
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