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The Ontario Travel Industry Compensation Fund Customer Claim

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The Ontario Travel Industry Compensation Fund
The Ontario Travel Industry Compensation Fund (The
Fund) provides reimbursement of monies (to a maximum of
$5,000.00 per person) paid to an Ontario registered travel
agency/website for travel services that are not provided due
to the bankruptcy or insolvency of an Ontario registered travel
agency/website or Ontario registered travel wholesaler or an
airline or cruise line, where a reimbursement has not otherwise
been provided. As long as the consumer has dealt through a
registered Ontario travel agency/website, a claim may be filed
against the Fund for the non-provision of travel services.
There are two types of claims that may be filed using
this form:
A Standard Claim is a claim for travel services that were paid
for but not provided as a result of the failure of a an Ontario
registered travel agency/website or an Ontario registered travel
wholesaler (tour operator). You must have purchased your
travel services from an Ontario registered travel agency/website
What is the eligible claim amount based on for a
Standard Claim?
The Fund only reimburses the amount paid for the original travel
services purchased from an Ontario registered travel agency/
website and not provided due to the bankruptcy or insolvency
of either a registered Ontario travel agency/website or a regis-
tered Ontario travel wholesaler (tour operator). The Compen-
sation Fund does not reimburse consumers for the cost of the
replacement (new) travel services purchased.
A Trip Completion Claim is a claim for reasonable expenses
incurred to complete a trip where a customer or another person
has commenced travel prior to the closure/failure of an Ontario
registered travel retailer or travel wholesaler and were unable
to receive the travel services purchased resulting in expenses
being incurred in destination (transportation, accommodation
and meals) to complete the trip.
**Trip Completion Claims are not eligible when the
non-provision of travel services is due to the closure/failure
of an airline or cruise line.
You must have purchased your travel services from an Ontario
registered travel agency/website to have an eligible claim.
What is covered for a Trip Completion Claim?
A consumer may only claim for the following reasonable
expenses related to trip completion:
• The cost of airfare, car hires or other transportation required
in order to bring the customer or other person to the final
destination. The individual may also be returned home if it is
preferable and does not exceed the cost to bring the person
to the final destination.
• The cost of necessary accommodation and meals for the
customer or other person before the trip can be completed.
• Costs related to obtaining access to money or making
financing arrangements to enable one to pay for the above
costs. For example, this could include costs of wire
transfers or costs of phone calls and faxes to arrange for
funds to be sent.
The Ontario Travel Industry
Compensation Fund
Customer Claim Form Package
Travel Agency or Travel Wholesaler
(Tour Operator) Failure
Who Should be the Claimant and Complete the Claim
form?
The individual who made payment to the Ontario registered
travel agency for the travel services that were not provided,
should complete the claim form. In some instances, it is
necessary for more than one person to complete a claim form
as one person may have paid the deposit and another person
may have paid the balance owing for the trip.
Filing Deadline for a Customer Claims
A claim must be filed within 6 months after the relevant TICO
registered travel retailer and/or travel wholesaler becomes
bankrupt or insolvent or ceases to carry on business. Claims
received beyond the filing deadline will not be valid, therefore is
it important to submit your claim immediately. Should you not
be able to obtain all the required supporting documenta-
tion in order to substantiate your claim in a timely manner,
please submit your claim with as much supporting
information as possible and send the additional
documentation when it is obtained to avoid late filing.
T
ICO’s Claims Process – What Happens Next
Once the ORIGINAL claim form is received at TICO, TICO’s
claims staff will send you a notice in writing acknowledging
receipt of your claim and providing you with your assigned
claim number. Claims are processed in the order of receipt
to ensure equitable treatment. If further information and/or
documentation is required TICO claims staff will contact you
in writing to request further information. Once a claim contains
all the required documentation, the claim will be presented
to TICO’s Board of Directors for its consideration. The Board
must ensure that each claim is eligible under Ontario Regulation
26/05. TICO will notify you in writing of the Board’s decision.
Appeal Process
In the event that the Board of Directors denies a claim,
claimants are advised that they have the right to appeal the
Board’s decision and request a hearing before the Licence
Appeal Tribunal (LAT). Full details on how to file an appeal with
LAT is provided to claimants with TICO’s written notice of the
Board’s decision. Should you have any questions about filing
a claim, please feel free to contact TICO to review your circum-
stances and obtain some guidance as to whether you may
have an eligible claim against the Travel Compensation Fund.
Please contact TICO at 1-888-451-8426 or (905) 624-6241 or
email: tico@tico.ca.
Please mail your ORIGINAL claim form and documentation to:
The Travel Industry Council of Ontario
Attn: Claims Department
55 Standish Court, Suite #460
Mississauga, Ontario
L5R 4B2
or email to: tico@tico.ca
CLOSURE/FAILURE DATE: FILING DEADLINE DATE:
CUSTOMER CLAIM
TRAVEL AGENCY OR TRAVEL WHOLESALER (TOUR OPERATOR) FAILURE
AMOUNT OF CLAIM $
CLAIM NO:
CLAIMANT:
FIRST NAME LAST NAME
ADDRESS APT/SUITE
CITY PROVINCE POSTAL CODE
TELEPHONE: HOME BUSINESS/CELL
EMAIL ADDRESS
CLAIM AGAINST:
NAME
ADDRESS SUITE
CITY PROVINCE POSTAL CODE
A CUSTOMER OR A REGISTRANT MAY MAKE A CLAIM IN WRITING TO THE BOARD OF DIRECTORS WITHIN
SIX MONTHS AFTER THE RELEVANT REGISTRANT BECOMES BANKRUPT OR INSOL
VENT OR CEASES TO
CARRY ON BUSINESS. A CLAIM MADE AFTER THE FILING DEADLINE IS NOT ELIGIBLE. PLEASE NOTE THE
FILING DEADLINE DATE ABOVE.
RECEIPT OF YOUR ORIGINAL CLAIM FORM WILL BE ACKNOWLEDGED IN WRITING. PLEASE CONTACT THE
TRAVEL INDUSTRY COUNCIL OF ONTARIO SHOULD YOU NOT RECEIVE AN ACKNOWLEDGEMENT WITHIN
TWO WEEKS OF SUBMITTING YOUR CLAIM.
Travel Industry Council of Ontario • 55 Standish Court, Suite 460, West Tower, Mississauga, Ontario L5R 4B2
Tel: (905) 624-6241 • Toll Free: 1-888-451-8426 • Fax: (905) 624-8631 • e-mail: tico@tico.ca • website:www.tico.ca
SINORAMA HOLIDAYS INC.
7077 KENNEDY ROAD
MARKHAM ON L3R 0B8
201
AUGUST 08TH, 2018 FEBRUARY 11, 2019
2
(b) TRAVEL INFORMATION
DEPARTURE DATE RETURN DATE PLACE OF ORIGIN DESTINATION
NUMBER OF PEOPLE TRAVELLING:
NAMES OF PASSENGERS: FIRST: LAST:
(c) IF APPLICABLE, INDICATE NAME OF ANY OTHER SUPPLIER OF TRAVEL SERVICES
(d) DID YOU RECEIVE A RECEIPT(S) IN EXCHANGE FOR YOUR PAYMENT(S)?
Yes No
(g) PAYMENT INFORMATION FOR ORIGINAL TRAVEL SERVICES PURCHASED
(e) ARE YOU IN POSSESSION OF TICKETS, VOUCHERS OR TRAVEL DOCUMENTS, WHICH CANNOT BE USED?
Yes No
(f) DID YOU USE / RECEIVE ANY OF THE TRAVEL SERVICES PURCHASED?
Yes No If so, what services were used / received?
IF PAID BY CREDIT CARD, HAVE YOU REQUESTED A REVERSAL (REFUND) OF CHARGE(S) FOR ANY TRAVEL
SERVICES THAT WHERE PAID FOR AND NOT PROVIDED FROM THE CREDIT CARD COMPANY?
Yes No (IF NO, SEE PAGE 6 – SECTION 6 (F))
PAYMENT
NUMBER
1 2 3 4 5
AMOUNT OF PAYMENT
DATE OF
PAYMENT
METHOD OF PAYMENT
(Cash/Cheque/Debit/
E-transfer/Credit Card)
1. ORIGINAL TRAVEL SERVICES PURCHASED
(a) NAME OF ONTARIO TRAVEL AGENT (AGENCY) OR WEBSITE FROM WHICH TRAVEL SERVICES WERE
PURCHASED:
HOW WAS THE BOOKING MADE? ON LINE BY PHONE IN PERSON
3
(h) BRIEFLY DESCRIBE THE TRAVEL SERVICES CONTRACTED FOR: (AIR ONLY, AIR & LAND PACKAGE,
CRUISE, ACCOMMODATION, CAR RENTAL ETC.)
(i) DID YOU TRAVEL ON THE ORIGINAL TRAVEL SERVICES PRIOR TO AUGUST 8TH, 2018 ?
Yes No
IF YES, WERE YOU REQUIRED TO PAY AGAIN IN DESTINATION FOR YOUR ORIGINAL TRAVEL SERVICES
PURCHASED (TRANSPORTATION, ACCOMMODATION AND/OR MEALS) IN ORDER TO CONTINUE WITH
YOUR TRAVEL PLANS?
Yes No IF YES PROCEED TO QUESTION #2.
IF NO, DID YOU PURCHASE ALTERNATE (NEW) REPLACEMENT TRAVEL SERVICES IN ORDER TO
CONTINUE WITH YOUR TRAVEL PLANS?
Yes IF YES PROCEED TO QUESTION # 3
No IF NO PROCEED TO QUESTION #4)
3. ALTERNATE (NEW) TRAVEL SERVICES PURCHASED
(a) NAME OF COMPANY TO WHICH PAYMENT WAS MADE FOR ADDITIONAL EXPENSES IN DESTINATION /
ALTERNATE (NEW) TRAVEL SERVICES:
(b) WHAT AMOUNT(S) WAS REQUIRED AS PAYMENT?
c) IF THE TRAVEL SERVICES WERE THE SAME AS QUESTION #1, CHECK HERE OR PROVIDE THE
FOLLOWING DETAILS:
2. ADDITIONAL EXPENSES INCURRED IN DESTINATION
(a) WHAT AMOUNT WAS REQUIRED AS PAYMENT FOR TRAVEL SERVICES PURCHASED IN DESTINATION?
PLEASE SUBSTANTIATE WITH RECEIPT(S) AND FORM(S) OF PAYMENT
AMOUNT OF PAYMENT DATE OF PAYMENT METHOD OF PAYMENT (CHEQUE/
CASH/DEBIT/E-TRANSFER/CREDIT CARD)
COMPANY/
TRAVEL SERVICE
DEPARTURE DATE RETURN DATE PLACE OF ORIGIN DESTINATION
AMOUNT OF PAYMENT DATE OF PAYMENT METHOD OF PAYMENT (CHEQUE/CASH/DEBIT/E-TRANSFER/CREDIT CARD)
4
4. ADDITIONAL INFORMATION
(a)
WAS TRAVEL INSURANCE PURCHASED?
Yes No If no proceed to (e)
(b)
WHAT IS THE NAME OF THE INSURANCE COMPANY?
PREMIUM PAID? DATE PAID?
POLICY NUMBER:
(c)
HAVE YOU FILED A CLAIM WITH THE INSURANCE COMPANY?
Yes No IF YES, WHEN WAS IT FILED?
IF NO, PLEASE ADVISE WHY A CLAIM WAS NOT FILED
(d)
DID YOU RECEIVE A REIMBURSEMENT FROM THE INSURANCE COMPANY?
Yes No
IF YES, HOW MUCH DID YOU RECEIVE $
(e)
HAVE YOU FILED A CLAIM WITH THE TRUSTEE IN BANKRUPTCY IF ONE HAS BEEN APPOINTED?
Yes No
IF YES, WHEN WAS IT FILED? TRUSTEE CLAIM NO:
IF NO, PLEASE ADVISE WHY A CLAIM WAS NOT FILED
NAME OF TRUSTEE IN BANKRUPTCY
ADDRESS
NUMBER OF PEOPLE TRAVELLING:
NAMES OF PASSENGERS: FIRST: LAST:
5
5. STATEMENT DISCLOSING YOUR RELATIONSHIP WITH THE TRAVEL AGENT / AGENCY
(I.E. THE TRAVEL AGENT FROM WHICH THE TRAVEL SERVICES WERE PURCHASED):
(f)
DESCRIBE THE CIRCUMSTANCES GIVING RISE TO THIS CLAIM:
IF YOUR ANSWER TO ANY OF THE ABOVE IS YES, PROVIDE DETAILS BELOW.
Yes/No
(1) HAVE YOU OR ANY OF THE PASSENGERS NAMED IN YOUR CLAIM FORM, EVER HAD AN
ASSOCIATION / RELATIONSHIP WITH THE TRAVEL AGENT / TRAVEL AGENCY THAT YOU
PURCHASED YOUR TRAVEL SERVICES FROM?
(2) HAVE YOU OR ANY OF THE PASSENGERS NAMED IN YOUR CLAIM FORM, EVER HAD ANY
INTEREST OR EXERCISED CONTROL EITHER DIRECTLY OR INDIRECTLY OVER THE TRAVEL
AGENCY’S BUSINESS?
(3) HAVE YOU OR ANY OF THE PASSENGERS NAMED IN YOUR CLAIM FORM, EVER PROVIDED
FINANCING EITHER DIRECTLY OR INDIRECTLY TO THE TRAVEL AGENT OR TRAVEL
AGENCY’S BUSINESS?
6
7. PLEASE ENSURE THE FOLLOWING HAS BEEN COMPLETED:
a) PAGE 6 MUST BE SIGNED AND DATED BY CLAIMANT
b) SUBROGATION FORM ON PAGE 7 MUST BE SIGNED AND DATED BY CLAIMANT
c) PAGES 8 AND 9 IS THE SWORN AFFIDAVIT OF THE CLAIMANT AND REQUIRES AN OATH TO BE
SWORN OR AN AFFIRMATION TO BE MADE BEFORE A COMMISSIONER OF OATHS, NOTARY PUBLIC
OR A LAWYER. FULL DETAILS MUST BE LEGIBLE INCLUDING PRINTED NAME OF COMMISSIONER
OF OATHS, NOTARY PUBLIC OR LAWYER, DATE OF EXPIRY OF COMMISSION (FOR COMMISSIONER
OF OATHS ONLY), FULL ADDRESS AND TELEPHONE NUMBER OF THE PERSON TAKING YOUR
AFFIDAVIT.
I HEREBY CERTIFY THAT THE INFORMATION GIVEN IN THIS CLAIM AND IN ALL DOCUMENTS ACCOMPANY-
ING THIS CLAIM IS TRUE, CORRECT AND COMPLETE IN EVERY RESPECT.
DATE SIGNATURE OF CLAIMANT
6. REQUIRED DOCUMENTATION TO BE SUBMITTED WITH CLAIM:
THE FOLLOWING ORIGINAL DOCUMENTS MUST BE SUBMITTED IN SUPPORT OF YOUR CLAIM;
PHOTOCOPIES ARE NOT ACCEPTABLE:
(a)
RECEIPT(S) AND INVOICE(S) ISSUED BY TRAVEL AGENT
(b)
ORIGINAL CHEQUE(S) IN PAYMENT TO TRAVEL AGENT
(ORIGINAL OR PHOTOCOPY OF FRONT AND BACK STAMPED “CERTIFIED & TRUE” BY YOUR BANK)
(c)
IF PAID BY CREDIT CARD, YOUR MONTHLY STATEMENT INDICATING THE CHARGE(S) MUST BE
SUBMITTED
(d)
IF APPLICABLE, WRITTEN PROOF OF REFUSAL BY THE INSURANCE COMPANY TO PROVIDE
REIMBURSEMENT
(e)
IF APPLICABLE, WRITTEN PROOF OF REFUSAL OR REIMBURSEMENT BY THE TRUSTEE IN
BANKRUPTCY
(f)
WRITTEN PROOF OF REFUSAL BY THE CREDIT CARD COMPANY TO PROVIDE REIMBURSEMENT
PLEASE NOTE: ALL CLAIMANTS WHO PAID BY CREDIT CARD FOR THE ORIGINAL TRAVEL SERVICES
NOT PROVIDED ARE REQUIRED TO CONTACT THEIR CREDIT CARD COMPANY TO DISPUTE THE
CHARGE AND REQUEST A CHARGEBACK (CREDIT / REVERSAL OF CHARGE) ON THEIR ACCOUNT.
IF DENIED, WRITTEN PROOF OF REFUSAL FROM THE CREDIT CARD COMPANY MUST BE SUBMITTED
IN SUPPORT OF YOUR CLAIM
(g)
IF ANY PAYMENTS HAVE BEEN DUPLICATED, OR IF ALTERNATE (NEW) TRAVEL SERVICES WERE
PURCHASED, PLEASE SUBSTANTIATE AS PER a), b) AND c) ABOVE
(h)
AIRLINE’S/CRUISE LINE’S/WHOLESALER’S INVOICE TO TRAVEL AGENT (YOUR TRAVEL AGENT
MUST SUPPLY)
(i)
TRAVEL AGENT’S ORIGINAL PAYMENT TO AIRLINE/CRUISE LINE/TRAVEL WHOLESALER (YOUR
TRAVEL AGENT MUST SUPPLY, IF APPLICABLE) (IF PAID BY CHEQUE ORIGINAL OR PHOTOCOPY OF
FRONT AND BACK STAMPED “CERTIFIED & TRUE” BY THE TRAVEL AGENT’S BANK)
(j)
ALL UNUSED TICKETS, VOUCHERS OR TRAVEL DOCUMENTS
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7
R E L E A S E A N D S U B R O G A T I O N F O R M
In consideration of the payment or partial payment of the claim of the undersigned by The Travel Industry Council of
Ontario (“TICO”), the undersigned claimant hereby discharges and forever releases TICO from all further claims, demands
and liability, loss and damage in relation to the claim. Provided, however, that this release shall, in the event of partial
payment of the claim of the undersigned, be applicable only to the extent of the claim of the undersigned actually paid.
TICO is hereby subrogated in the place of, and to all rights to recovery, claims and demands of the undersigned against
any person or organization, including but not limited to, SINORAMA HOLIDAYS INC. which includes its subsidiaries,
parent companies, successors, agents and assigns any party claiming through them to the extent of the payment made.
The undersigned further authorizes TICO to commence any action and/or proceeding, compromise, adjust or settle any
action and/or proceeding in the name of the undersigned or otherwise at the expense of TICO, with respect to the claim to
the extent of any payment made by TICO with respect to the claim. Where only a portion of the undersigned’s claim has
been paid by TICO, it is hereby authorized to act as the undersigned’s agent with respect to the balance of the claim of the
undersigned and in that regard, is empowered to commence any action or proceeding, compromise, adjust or settle any
action and/or proceeding in the name of the undersigned or otherwise at the expense of TICO, including the giving of
releases in the name of the undersigned for such part of the undersigned’s claim not subrogated herein. Any monies
recovered by TICO or on its behalf shall be applied firstly towards the costs incurred in recovering the said monies and
secondly towards that portion of the claim paid by TICO and the balance, if any, shall be remitted by TICO to the
undersigned.
It is understood and agreed that in the event a further payment is received by the undersigned from TICO, this Release and
Subrogation shall apply to such further payment without re-execution of this document.
The undersigned hereby confirms that it has not received payment or reimbursement of the said claim from any other
source and that the undersigned has not released or discharged the said claim, or any part thereof, against any other
person or corporation and covenants that it will furnish TICO with all papers and information in its possession and
execute such documents and do everything in its power necessary for proper litigation of the said claim. In the event that
the undersigned receives any payment or reimbursement of the said claim from any other source subsequent to the date
hereof, the undersigned agrees to immediately advise TICO of such payment or reimbursement and immediately remit such
payment and/or reimbursement to TICO.
IN WITNESS WHEREOF the undersigned hereby executes this document dated
THE DAY OF 20
Printed Name of Claimant Signature of Claimant
Claimant’s Address
Printed Name of Witness Signature of Witness
IF THE TRAVEL INDUSTRY COUNCIL OF ONTARIO FAILS TO MAKE PAYMENT OF THE CLAIM, THIS DOCUMENT IS
NULL AND VOID
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8
A F F I D A V I T O F C U S T O M E R C L A I M A N T
IN THE MATTER OF A CLAIM FOR REFUND FROM THE TRAVEL INDUSTRY COUNCIL OF ONTARIO UNDER THE
TRAVEL INDUSTRY ACT, 2002, S.O. 2002, CHAPTER 30 SCHEDULE D AS AMENDED AND THE REGULATIONS
THERETO:
I, OF THE
NAME OF CLAIMANT CITY/TOWN, ETC.
OF IN THE
NAME OF CITY/TOWN, ETC. COUNTY / DISTRICT / REGIONAL MUNICIPALITY
OF MAKE OATH AND SAY AS FOLLOWS:
NAME OF COUNTY / DISTRICT / REGIONAL MUNICIPALITY
1. THAT I AM THE CLAIMANT IN THIS MATTER AND AS SUCH HAVE PERSONAL KNOWLEDGE OF THE MATTERS
HEREINAFTER SWORN TO.
2. THAT ON THE DAY OF ,20 , I AGREED
WITH TO PURCHASE THROUGH
(NAME OF TRAVEL AGENCY) (NAME OF SUPPLIER OF TRAVEL SERVICES)
TRAVEL SERVICES WHICH WERE TO CONSIST OF
(GIVE BRIEF DESCRIPTION OF TRAVEL SERVICES CONTRACTED FOR)
3. THAT ON THE DAY OF , 20 , I PAID
TO BY WAY OF CASH, CHEQUE OR CREDIT CARD,
(NAME OF TRAVEL AGENCY)
(INDICATE WHICH), THE SUM OF WHICH AMOUNT REPRESENTED THE DEPOSIT ON THE
PURCHASE PRICE OF THE TRAVEL SERVICES. ATTACHED HERETO AND MARKED EXHIBIT “A” TO THIS MY
AFFIDAVIT IS THE RECEIPT, CANCELLED CHEQUE OR CREDIT CARD VOUCHER GIVEN TO ME BY
(NAME OF TRAVEL AGENCY)
DATED THE DAY OF , 20 , RESPECTING THIS PAYMENT.
4. THAT ON THE DAY OF , 20 , I PAID
TO BY WAY OF CASH, CHEQUE OR CREDIT CARD,
(NAME OF TRAVEL AGENCY)
(INDICATE WHICH), THE SUM OF WHICH AMOUNT REPRESENTED THE BALANCE OF
THE PURCHASE PRICE OF THE TRAVEL SERVICES. ATTACHED HERETO AND MARKED EXHIBIT “B” TO THIS
MY AFFIDAVIT IS THE RECEIPT, CANCELLED CHEQUE OR CREDIT CARD VOUCHER GIVEN TO ME BY
(NAME OF TRAVEL AGENCY)
DATED THE DAY OF , 20 , RESPECTING THIS PAYMENT.
5. I CONFIRM THAT I HAVE NOT USED / RECEIVED ANY OF THE TRAVEL SERVICES FOR WHICH I AM MAKING
A CLAIM FOR REIMBURSEMENT.
9
6. ANY TRAVEL SERVICES THAT WERE PROVIDED HAVE BEEN PROPERLY DISCLOSED ON THE CLAIM FORM.
7. THE INFORMATION CONTAINED IN THE ATTACHED CLAIM FORM AND IN THE DOCUMENTS ATTACHED
THERETO IS TRUE AND COMPLETE IN EVERY RESPECT. THIS AFFIDAVIT IS MADE IN SUPPORT OF MY CLAIM
FROM THE TRAVEL INDUSTRY COUNCIL OF ONTARIO.
I UNDERSTAND AND ACKNOWLEDGE THAT THE MAKING OF A FALSE STATEMENT UNDER OATH OR
SOLEMN AFFIRMATION, SUCH AS THIS AFFIDAVIT, OR STATUTORY DECLARATION, MAY BE AN OFFENCE
UNDER SECTION 131 OF THE CRIMINAL CODE OF CANADA, R.S.C. 1985, C. C-46, AND MAY DISENTITLE ME
FROM COMPENSATION.
SWORN BEFORE ME AT THE OF }
}
IN THE OF }
SIGNATURE OF CLAIMANT
THIS DAY OF A.D. 20 }
A Commissioner, etc.
Signature of Official Taking the Affidavit Name of Official (Print)
Address of Official Taking the Affidavit Telephone Number of Official
Stamp or Seal of Official
PLEASE NOTE: THIS IS THE SWORN AFFIDAVIT OF THE CLAIMANT AND REQUIRES AN OATH TO BE SWORN
OR AN AFFIRMATION TO BE MADE BEFORE A COMMISSIONER OF OATHS, NOTARY PUBLIC OR A LAWYER.
FULL DETAILS MUST BE LEGIBLE INCLUDING PRINTED NAME OF COMMISSIONER OF OATHS, NOTARY PUBLIC
OR LAWYER, DATE OF EXPIRY OF COMMISSION (FOR COMMISSIONER OF OATHS ONLY), ADDRESS AND
TELEPHONE NUMBER OF THE PERSON TAKING YOUR AFFIDAVIT.
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The Ontario Travel Industry Compensation Fund Customer Claim

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Completed 25 May 2022

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