Compliance Complaint Form

Compliance Complaint Form - Print

Please complete as much of the complaint form as possible. This will assist Access Copyright in assessing and investigating your complaint. The information you provide will remain confidential and will not be made public without your permission. It will only be used for the purpose of investigating your complaint. Note, we can only pursue complaints relating to Canadian rightsholders.

Contact Information
Your Name :
Address :
City :
Province :
Postal Code :
Telephone :
Fax :
Email :
Infringement Information
In the text boxes below, provide as much detail as possible regarding your complaint. If you have any documents relating to your complaint, please retain them.
When :
Where :
Names and phone numbers of any witnesses (if any) :
Copies of receipts? YesNo
Do you have a copy(ies) of the infringing work? If so, please retain it/them. YesNo
Title(s) of Infringed Work(s) :
Author(s) :
Publisher & Country :
ISBN or ISSN:
Pages copied :
Additional details :