Whistleblower Report Form

This Form is to be completed by Bank employees who have reasonable grounds to believe that the Bank has committed or intends to commit a wrongdoing in relation to the Bank's financial consumer protection obligations.

If you are not a Bank employee or have any questions that fall outside this program, please contact the Consumer Information Centre. FCAC does not resolve individual complaints, but the Consumer Information Centre can help you understand your bank's complaint process.

Before submitting a report of wrongdoing by a Bank, please read about the Financial Consumer Agency of Canada's (FCAC's) Whistleblower Program for Employees of Federally Regulated Banks. You may submit your report online or by mail. In either case, we ask you to use this Form.

The Form takes about 30 minutes to complete. If you are submitting it online, for security reasons, your session will be timed out after 30 minutes of inactivity, and the information you have entered will not be saved. Changes to the Form cannot be saved while it is being completed.

To submit a report by mail instead, download a printable copy of the Form, fill it out and mail it to:

Financial Consumer Agency of Canada
Enforcement Division
427 Laurier Avenue West, 5th Floor-Reception
Ottawa, Ontario
K1R 7Y2

Before you submit a Whistleblower Report, please ensure that the wrongdoing relates to the breach of a bank’s financial consumer protection measures (also known as market conduct obligations) as set out in applicable legislation, regulation, codes of conduct and public commitments, as well as policies and procedures established by the Bank.

FCAC expects you to provide only information that is currently in your possession or control. Please don’t include any documents with your Form. FCAC will contact you if additional information or documents are needed.

All fields are optional

Your contact information

Name

First name

Last name

Home address

Street

City

Province

Postal Code

Contact preferences

Phone

Preferred method of communication

Other Preferred Method, please specify

Preferred language of correspondence

Information about the Bank(s) involved in the wrongdoing

Bank Name

Please specify the name of the bank.

Bank address: (if known, address where wrongdoing occurred, is occurring or will occur)

Street

City

Province

Postal Code

Your employment status with the Bank at the time of reporting (title and status)

Specify the employment status

Title or previous title

If more than one Bank is involved

Additional bank name

Selected Entities

Please specify the name of the bank.

Facts of the wrongdoing

Describe the facts of the wrongdoing. Be as specific as possible.

To the best of your knowledge, please include answers to as many of the following questions as possible

When did the wrongdoing occur? Did it occur in the past, is it currently ongoing, and/or will it occur in the future? If known, please provide specific dates or date ranges.

What product(s) and/or service(s) were involved?

Product

Selected Products

Please enter the product you are reporting on

Service

Selected Products

Please enter the service you are reporting on

Were customers affected by the wrongdoing? Please explain.

Please provide more details

Who are the individual(s), group(s), or department(s) involved in the wrongdoing? If known, what are their position(s) or role(s) within the Bank?

How did you learn about the above wrongdoing?

Additional information

Have you raised your concerns regarding this wrongdoing with anyone else, such as your employer, another government agency or law enforcement? If so, please explain to whom you raised your concerns (for example, please provide the name of organization and/or persons), and provide the date(s) on which you shared them.

Please specify

Is there anything else you would like to tell us?

Please specify

Do you currently have any documents in your possession or control to support the allegation of wrongdoing?

Whistleblower declaration

Your identity and any information you provide to FCAC will be kept confidential under applicable laws.

Please review all your information before submitting to FCAC.

By clicking this box, I certify that all the information submitted through this form is true and accurate to the best of my knowledge.