Application (Form 5)

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Who should use this form?

An applicant.


To start a dispute proceeding before the Agency.

When should you file this form?

You are expected to have tried to resolve the dispute with the respondent yourself before filing an application with the Agency. In some instances, the Agency will not consider your application until it is satisfied that you have taken this step.

You should file your application as soon as possible after failing to resolve your dispute with the respondent to reduce the risk that relevant documents are not kept by all parties and to ensure that all options for relief are available to you.

What happens next?

You will be informed if your application is complete and, if so, the start date of the proceeding.

If your application is incomplete, you will be notified in writing and you must provide the missing information within 20 business days after the date of the notice. If you fail to provide the missing information within the time limit, your file will be closed.

Refer to section 18 of the Dispute Adjudication Rules for more information.

Personal information collection statement
Privacy Statement

All personal information created, held or collected by the Canadian Transportation Agency (Agency) is protected under the Privacy Act. This means that you will be informed of the purpose for which it is being collected and how to exercise your right of access to that information. You will be asked for your consent where appropriate.

The information provided in this form is collected in order to allow us to process your application. The personal information is collected pursuant to the Canada Transportation Act. The information is included in the personal information banks:

Any personal information the Agency receives from the online form is only provided to those members of our staff and Members who require it in order to respond to your application. The information may be shared with transportation service providers and any other parties involved in order to resolve your dispute.

As per the open court principle and the Canadian Transportation Agency Dispute Adjudication Rules, all information filed with the Agency as part of an adjudicated dispute becomes part of the public record and may be made available for public viewing. For adjudicated disputes, the Agency posts applications, pleadings documents and decisions issued on its website. For further information please see our Privacy Policy.

The information you submit on the online form will be encrypted (a secure means of transmission) when it is sent electronically to the Agency. For your reference purposes, the information you submit is temporarily retained in an encrypted folder on a secure server hosted on our internal network until 30 days following the issuance of a decision or upon withdrawal of your application and Agency acceptance. The information is stored in the Agency Corporate Repository and Case Management System where it will be retained for 10 years upon file closure, and then destroyed.

If after reading this statement, you prefer not to submit your application via the Internet, you may use one of the following methods:

By Courier or in Person: Canadian Transportation Agency, 60 Laval Street, Unit 01, Gatineau, Quebec, J8X 3G9

By Teletypewriter: 1-800-669-5575

If you do not provide all of the required information on this form, the Agency will not be able to begin processing your application.

Privacy Inquiry

You have the right to request access to your personal information and also to request corrections if you believe that your personal information is erroneous or incomplete.

Any questions, comments, concerns or complaints regarding the administration of the Privacy Act and privacy policies may be directed to the departmental Privacy Coordinator by email to, by calling 819-743-7259 or writing to: Access to Information and Privacy Coordinator, 60 Laval Street, Unit 1, Gatineau, Quebec, J8X 3G9.

If you are not satisfied with our response to your privacy concern, you may wish to contact the Office of the Privacy Commissioner by e-mail at or by telephone at 1-800-282-1376.

Who is filing this form?
Fill out your contact information in the "Applicant" section below.
Add the contact information of any other applicant(s) by clicking the "Add another applicant" button.
If you are filing this application on behalf of a company, an association or other organization, identify yourself and provide the contact information for the organization.
Fill out your contact information in the "Representative" section.
Add the contact information for whoever you're representing in the "Applicant" section below.
Contact information: Lawyer
Contact information: Representative
Contact information: Applicant(s)

Contact information: Organization(s)