Government of Ontario

Financial Services Commission of Ontario
5160 Yonge Street
Box 85
Toronto ON  M2N 6L9

Dispute Resolution Services

Response to Application
Variation/Revocation
Form M

Complete ALL sections.
Attach extra sheets if necessary.

APPLICANT FOR VARIATION/REVOCATION

     


RESPONDENT’S NAME AND ADDRESS

     











RESPONDENT’S REPRESENTATIVE

     













The representative is:

   
   

      

RESPONSE TO APPLICATION FOR VARIATION/REVOCATION



RESPONSE TO PRELIMINARY MATTERS



SIGNATURE AND CERTIFICATION

I certify that all information in this Response to Variation/Revocation and attachments is true and complete. I realize that copies of all information filed with this Response to Variation/Revocation will be given to the other party in this dispute.