Appeal of Victims' Rights Decision

Should you have any questions when completing this form, please call the Scheduling Co-ordinator at (204) 925-6116 (collect).

Fields marked with (*) are required.

Section A: Claim Information

Section B: Representative Information

If you will be represented on your appeal, you must provide a separate signed and dated authorization naming your representative.

Section C: Language Interpretation

Any required interpretation services will be arranged by the Appeal Commission.

Section D: Decision Appeal Information

Maximum length: 800 characters

Maximum length: 800 characters

Section E: Appeal Method

Please indicate by which method you wish to pursue your appeal (select one)

Maximum length: 800 characters

The Chief Appeal Commissioner has the final authority to determine the method of appeal.

Once the request has been sent, you will also receive a copy of your application via email. Please save or print the PDF for your records.