Please fill out this form as completely as possible to help ASC to identify the advertisement and to help us to respond to you. When complete, press the "Send Complaint" button to submit the complaint to ASC. Information marked with (*) is required. For print advertising, forward a copy of the advertisement to ASC.

If possible, attach a copy of the advertisement.
Mail
 Advertising Standards Canada
175 Bloor St. E, South Tower, Suite 1801
Toronto, ON M4W 3R8 		Fax
 (416) 961-7904

 Attachment

Information marked with (*) is required.

Your Contact Information
*Name
*Full Mailing Address
Phone
*E-mail Address


About the Advertisement
*Who is the Advertiser?
*What is the Product or Service advertised?
*Where did you see the advertisement?
*When did you see the advertisement?
Description of advertisement



Your Complaint
*Complaint


ASC cannot process consumer complaints from persons who are affiliated with a competitor of the advertiser or its agents. To enable ASC to process this complaint, please confirm the following:
*I confirm that neither I nor any member of my household has any affiliation with a competitor of the advertiser or the advertiser’s advertising agency.
Before we can proceed with your complaint, to comply with privacy regulations, ASC requires permission to share the information you provided with various parties. Please select one of the following:
I give consent to ASC to disclose my name, contact information, and a copy of this complaint to ASC and the Consumer Response Council for the purpose of reviewing the complaint, and for the purpose of providing further information about ASC’s activities. I also give consent to ASC to disclose my name, contact information, and a copy of this complaint to the advertiser for the purpose of responding to my concerns.

 I give consent to ASC to disclose my name, contact information, and a copy of this complaint to ASC and the Consumer Response Council for the purpose of reviewing the complaint, and for the purpose of providing further information about ASC’s activities. I give consent to ASC to forward a copy of this complaint to the advertiser, but I do not give consent to ASC to disclose my name and contact information to the advertiser for the purpose of responding to my concerns.