Traffic Citation Appeal Request Form
Please fill out the form below completely and click on the submit button at the bottom of the form.
Once we have received your request we will notify you of our decision as soon as we have looked into the case and reached a decision.
Driver's License Number
State:
Please Select
Canada
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
First Name
Middle Name
Last Name
Street Address
City
State
Zip
Cell Phone
Home Phone
Email
Please provide information as it appears on the Citation
Day of Week Citation was Issued:
Day:
Choose day
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Date Citation was Issued
Time Citation was Issued
Time:
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Citation number of the citation you are appealing:
Offense
Location of Offense
Please Select
5: Dixie Parking Garage
A: Okeechobee Parking Lot
B: Greene Complex Parking Lot
C: Athletics Parking Lot
D: Intramural Field Parking Lot
E: The Q Parking Lot
F: Admissions North Parking Lot
G: Athletics Parking Lot
H: Flagler Towers
I: Lakeview Parking Lot
J: Memorial Presbyterian Church Auxillary Parking Lot
K: Memorial Presbyterian Church North Parking Lot
L: Chadbourne Parking Lot
M: Family Church East Parking Lot
N: Family Church West Parking Lot
O: PBCA East Parking Lot
P: Rinker Parking Lot
Q: Coastal Towers Parking Lot
R: Borbe Parking Lot
S: Sachs Parking Lot
T: Christian Science Parking Lot
U: Esperante Parking Lot
Z: PBCA East
Z: Mango Promenade North Parking Lot
Z: Mango Promenade South Parking Lot
Z: Other - City Parking
Z: Other - Street Parking
Z: Other (explain in narrative)
Your parking decal number:
Your license tag number and state:
Tag:
State:
Please Select
Canada
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Make of car:
Model of car:
Year of car:
Clearly state the reason(s) why you are appealing the citation: