HomeMy WebLinkAboutDog Designation Appeal Hearing Request FormDOG DESIGNATION APPEAL HEARING REQUEST
FORM
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, Legislated Services — 200 King Street West, 2nd Floor
P.O. Box 1118, Kitchener ON N2G 4G7
519-741-2203, clerks (a)kitchener.ca
The original copy of the Notice of Appeal Form must be received on or before 5:00 p.m. on the final date for appeal
at: City of Kitchener, Legislated Services, Attention: Dog Designation Appeal Committee Secretary.
Appeals received after the date of appeal listed on the Designation will not be processed and will not be heard by
the Committee.
Note: If you request an appeal hearing:
• you will receive a Notice of Hearing to attend the Dog Designation Appeal Committee meeting;
the Notice of Hearing will be sent by Registered Mail only to the address you provide below;
the recommendation of the Committee is not final until ratified by City Council; and,
City Council may confirm, rescind, modify, or substitute any recommendation from the Committee.
1. DOG OWNER (APPELLANT) INFORMATION
Name: Phone:
Street Address: F7ma il-
City/Province: Postal Code:
2. DOG CO-OWNER (APPELLANT) INFORMATION (If applicable)
Name: Phone:
Street Address:_ Email:
CitylProvince: Postal Code:
3. DOG DEISNATION INFORMATION
Date Designated:
Type of Designation: Ll POTENTIALLY DANGEROUS ❑ DANGEROUS ❑ PROHIBITED ❑ RESTRICTED
Appealing: ❑ the entire designation ❑ only specific conditions of the designation
Please outline the reason for your appeal including any concerns with specific conditions of the
designation:
4. PRE HEARING REQUEST
The Animal Welfare Agency South Central Ontario has been contracted to enforce the City's animal control by-laws; accordingly,
the City's Legal Services will represent the City at the appeal hearing. The Animal Welfare Agency South Central Ontario's officer
may be called as a witness by the Legal Services at the appeal hearing. Please indicate below if you would like to meet with the
City's Prosecutor in advance of the appeal hearing to discuss the designation. Please note, the City's Prosecutor does not
represent you and will not provide you with any legal advice.
❑ Yes ❑ No
Signed this day of . 20_,
Dog Owner's Signature(s)