Please fill out this form as completely as possible within 15 days of the date of the ticket for which the complaint is being made.
Note: Personal information on this form is being collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act R.S.O. c. F.31, s.39(2). Questions about the collection of personal information may be directed to the Township of Brock, 1 Cameron St. E., Box 10, Cannington, Ontario, L0E 1E0.
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