Form 16 (Complaint against CSIS)

National Security and Intelligence Review Agency (NSIRA) – FORM 16

SECTION A – PERSONAL INFORMATION

Title
Last Name
First Name
 
 
 
Address
 
Telephone number

Date of Birth

 
 
Email
 

 

Specific Allegations against the Canadian Security Intelligence Service (CSIS):



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You must first file a complaint by writing to the Director of CSIS at the following address:

Director
Canadian Security Intelligence Service
P.O. Box 9732
Postal Station T
Ottawa, ON K1G 4G4

If you are not satisfied with the Director’s response, or if you do not receive a response within a reasonable time (usually 60 days), you may then submit your complaint to NSIRA.

You may contact NSIRA at the following address:

National Security and Intelligence Review Agency
P.O. Box 2430
Station D
Ottawa, ON K1P 5W5

Once your complaint is received, NSIRA will contact you to follow up on the information you provided. For further information, please contact the Registrar at 1-833-890-0293.

SECTION B – DETAILS OF MY COMPLAINT



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SECTION C – CERTIFICATION

□ I have sent a complaint letter to the Director of CSIS

□ I have attached a copy of my letter of complaint to the Director of CSIS

□ I am dissatisfied with the response from the Director of CSIS

□ I have not received a response from the Director of CSIS within 60 days

□ I have attached the response from the Director of CSIS, if any


Signature:
 
Date:
 

 

PROTECTED B WHEN COMPLETED – PERSONAL INFORMATION

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