Certificate of Service
(Disponible en français)
File Number
Address of Rental Unit:
Unit /Apt. /Suite: Street Address:
Municipality (City, Town, etc): Postal Code:
I, , certify that on
/ /
I gave a copy of the following document(s):
Notice of Termination Form # Motion to Set Aside an Ex Parte Order
Application Form # Request to Review an Order
Notice of Hearing Other
to the following person(s):
(insert name of document )
the tenant the landlord other
(insert the name of the person you gave the document to)
more than one tenant, who is a party to the same application, on the same date and in the same way.
(If you shade this circle, attach a list of the names and addresses of the people you served.)
by the following method of service:
handing the document(s) to the person(s).
handing the document(s) to an authorized employee of the landlord.
handing the document(s) to an adult person in the tenant's rental unit.
leaving the document(s) in the mailbox, or place where mail is normally delivered.
placing the document(s) under the door of the rental unit or through a mail slot in the door.
sending the document(s) by courier to the person(s).
sending the document(s) by fax to fax number:
sending the document(s) by mail or Xpresspost to the last known address of the person(s), at:
a different method of service (provide details)
1. The only document that can be properly served by posting it to the door of the rental unit is a notice of intent to enter
a rental unit given under section 27 of the Residential Tenancies Act, 2006, unless a Member orders otherwise
pursuant to the Landlord and Tenant Board's Rules of Practice.
2. It is an offence under the Residential Tenancies Act, 2006 to file false or misleading information with the Landlord and
Tenant Board.
Landlord Tenant Representative Other
First Name
Last Name
Phone Number
( )
v. 30/11/2015
Signature (the person who served the documents must sign the form) Date (dd/mm/yyyy)
Delivery Method:
In Person Mail Courier Email Efile Fax
Under section 185 of the Residential Tenancies Act, 2006, the Landlord and Tenant Board has the right to collect the personal information requested on this
form. We use the information to resolve your application. After you file the form, your information may also be available to the public. If you have questions
about how the Board uses your personal information, contact one of our Customer Service Officers at 416-645-8080 or 1-888-332-3234 (toll free).