Complaint Form/affidavit Page 2

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3.I acknowledge that at the time of the Integrity Commissioner’s report to Council in this matter,
and as between the parties, the identity of a complainant and the identity of the person
who is the subject of the complaint shall not be treated as confidential information.
Please see the attached Schedule A.
1.This Affidavit is made for the purpose of requesting that this matter be reviewed and for no
other purpose.
SWORN [or AFFIRMED] before me at the [City,Town, etc. of]
In the Province of Ontario on:
______ [Day }of _______________ [Month] _______ [Year]
________________________________________
____________________________________
[Signature of Commissioner]
*Please print Commissioner’s Name+
A Commissioner for taking Affidavits, etc.
Code of Conduct Complaint Protocol s.2(3) Formal Complaint Procedure. Please note that
signing a false affidavit may expose you to prosecution under Sections 131 and 132 or 134 or
the Criminal Code, R.S.C. 1985, c. C-46, and also to civil liability for defamation.

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