Request For Hearing In The Independent Assessment Process (Iap)
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2PO Box 1575, Stn "B" Ottawa, ON K1P 0A9
CP 1575, SUCC «B» Ottawa, ON K1P 0A9
IAP File Number:
Claimant’s Name:
Priority:
Harm:
Counsel File Number:
Counsel’s Name:
Track:
Loss:
Request for Hearing
in the Independent Assessment Process (IAP)
I am writing on behalf of my client ________________________________________ to request a hearing
for file _____________________________.
I confirm that I have submitted all mandatory documents that I intend to/am able to submit in
support of the harm and loss levels being claimed in this file, as required by Schedule D of the Indian
Residential School Settlement Agreement. Please see the Mandatory Document Checklist, attached.
Please provide a list of all documents included in this package for verification purposes.
The Mandatory Document Checklist can now be filled in PDF at:
Claimant Preferences
My client’s preference for Adjudicator Gender:
Male
Female
No Preference
My client agrees to a representative from the Church attending his/her hearing
Yes
No
No Preference
My client would like a Health Support Worker to attend his/her hearing:
Yes
No
No Preference
If yes, my client prefers:
Male
Female
No Preference
My client requires an interpreter:
Yes
No
Tribal Language: ______________
Dialect: _______________________
My client presently lives at: ____________________ (City, town, community), ____________________ (Province /Territory)
DNC 64 – Request For Hearing
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DNC 64 – Demande d’audience
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