Legal Advice Request Form
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Legal Advice Request Form
Submit completed form to:
Office of the Public Sector Integrity Commissioner of Canada
60 Queen Street
Ottawa, Ontario K1P 5Y7
Telephone: 1-866-941-6400
Fax: 613-946-2151
(A) General Contact Information
Name:
Title (optional):
Address where you would like to be contacted:
Telephone number(s) at which you would like to be contacted:
Fax (optional):
E-Mail (optional):
Federal Sector Public Servant
Not a Federal Sector Public Servant
(B) Information on the File
Disclosure File
Reprisal File
Name of the organization involved
File number (if available):
(C) Absence of Free Legal Advice from Other Source(s)
Are you member of a union or a professional association? yes no
If yes, have you requested access to legal advice from your union or professional association on the subject-matter to which this application relates? yes no
If yes, what was the response? granted denied
Have you requested access to legal advice from your employer on the subject-matter to which this application relates? yes no
If yes, what was the response? granted denied
Are you eligible for a provincial or territorial legal aid regime? yes no
Explanatory Notes:
Subsection 25.1(2) of the Act provides that the Commissioner may provide the access to legal advice only if the Applicant satisfies him that he does not have other access to legal advice at no cost.
(D) Amount requested:
up to $1,500
up to $3,000 *
* If you are requesting for an amount up to $3,000, please describe the exceptional circumstances which may adversely affect you and would justify such an amount:
Explanatory Notes:
Subsection 25.1(4) of the Act provides that the maximum amount that may be paid by the Commissioner is $1, 500.
Subsection 25.1(6) of the Act provides that, if the Commissioner is of the opinion that there are exceptional circumstances, the maximum amount is deemed to be $3,000.
(E) Declaration
I declare that all the information provided in the current request is true.
Signature
Date