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:
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:
Date Citation was Issued
Time Citation was Issued Time:
Citation number of the citation you are appealing:
Offense
Location of Offense
Your parking decal number:
Your license tag number and state: Tag: State:
Make of car:
Model of car:
Year of car:
Clearly state the reason(s) why you are appealing the citation: