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SECTION I – IDENTIFICATION OF BROKER(S) OR PERSON(S) CONCERNED BY THE APPLICATION
BROKER OR PERSON CONCERNED #1
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SECTION II – INFORMATION ON THE TRANSACTION CONCERNED
Important dates
SECTION III – OTHER PERSONS CONCERNED OR WITNESSES
Are there any other persons or witnesses involved?
Person concerned or witness #1
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SECTION IV – STEPS TAKEN TO SOLVE YOUR PROBLEM
SECTION V – PARTICULARS OF THE REQUEST FOR ASSISTANCE

Give details of the reasons for your request for assistance which lead you to believe that a fault, error or offence has been committed. Give a chronological description of the events, indicate the date and place of the events and describe the damage caused.

The alleged facts must be proved by providing a copy of all relevant documents, such as:

  • Brokerage contract
  • Declarations by the seller of the immovable
  • Promise to purchase
  • Email and text message exchanges
  • Letters
  • Invoices
  • Photos
  • Other

Make sure you keep the originals of your documents.

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SECTION VI – IDENTIFICATION OF ASSISTANCE APPLICANT(S)
Applicant #1

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SECTION VII – IDENTIFICATION OF THE PERSON(S) AFFECTED BY THE SITUATION
Identify the person(s) affected by the situation referred to in your request for assistance.
Person #1
Please provide the contact information of the person affected by the situation.
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SECTION VIII – DECLARATIONS

I certify that the information contained in this Request for assistance is complete and accurate. I undertake to fully cooperate with the OACIQ staff by providing, if applicable, additional information or documents that may be required.

I understand that my request and all the documents provided may be forwarded to the Fonds d'assurance responsabilité professionnelle du courtage immobilier du Québec (FARCIQ) and to the Fonds d'indemnisation du courtage immobilier (FICI) if the situation so requires.

I understand that my request does not have the effect of interrupting the legal period within which I am required to institute legal proceedings and assert my rights before civil courts. This limitation period is usually three years.

I understand that the OACIQ does not provide legal advice. The OACIQ suggests that I seek the help of a legal counsel who will be able to inform me about my rights and remedies.

I understand that I cannot withdraw my Request for assistance once it is sent to the OACIQ.

SECTION IX - CLAIM
Do you wish to make a claim?

You must prove the amounts you are claiming by attaching supporting documents such as schedules, documents describing the building, bids or estimates, invoices, e-mail exchanges, etc. Be sure to keep the originals of these supporting documents.

SECTION I - IDENTIFICATION OF CLAIMANT(S)
Claimant #1

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SECTION II - IDENTIFICATION OF LICENCE HOLDER(S) (BROKER(S) OR AGENCY(IES)) CONCERNED BY YOUR CLAIM
Licence holder #1

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SECTION III - IDENTIFICATION OF BROKER(S) CONCERNED BY YOUR CLAIM
Damage #1
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Total amount claimed ($)

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SECTION IV - STEPS TAKEN REGARDING YOUR CLAIM
SECTION V – CLAIM TO THE REAL ESTATE INDEMNITY FUND (FICI)
SECTION VI – CLAIM TO THE FONDS D'ASSURANCE RESPONSABILITÉ PROFESSIONNELLE DU COURTAGE IMMOBILIER DU QUÉBEC (FARCIQ)
SECTION VII – DECLARATIONS

I certify that the information contained in this Annex - Claim is complete and accurate. I undertake to fully cooperate with the OACIQ staff by providing, if applicable, additional information or documents that may be required.

I understand that my claim and all the documents provided may be forwarded to the Fonds d'assurance responsabilité professionnelle du courtage immobilier du Québec (FARCIQ) and to the Real Estate Indemnity Fund (FICI) if the situation so requires.

I understand that my claim does not have the effect of interrupting the legal period within which I am required to institute legal proceedings and assert my rights before civil courts. This limitation period is usually three years.

I understand that the OACIQ does not provide legal advice. The OACIQ suggests that I seek the help of a legal counsel who will be able to inform me about my rights and remedies.

SECTION X – SIGNATURE OF ASSISTANCE APPLICANT(S)

By checking this box, I agree, as an applicant, to submit this request for assistance.

We have received your request.
Rest assured that it will be assigned to an analyst, and we will follow up on it as soon as possible.
Visit the Public Assistance Department section to learn more about the next steps.