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Department of Parking and Transportation

UNIVERSITY ISSUED PARKING CITATION AND TOWING /

VEHICLE IMMOBILIZATION APPEAL FORM

An Appeal Hearing Officer will review this appeal pursuant to University Rule 6C13-1.003.

This appeal form must be received by the Department of Parking and Transportation no later than ten (10) business days from the

date the citation was issued or the appeal will be denied.

COUNTY CITATIONS ARE NOT OPEN TO APPEAL THROUGH THIS PROCESS.

Appeal is related to:

PARKING CITATION

TOWING / IMMOBILIZATION / IMPOUNDING

NOTE: Towing / Impounding / Immobilization procedure or charges will be reviewed within 2 business days after receipt of Appeal Form

UNIVERSITY EMPLOYEE

STUDENT

VISITOR

VENDOR/CONTRACTOR

PLEASE PRINT THE INFORMATION REQUESTED BELOW

STUDENT/UNIVERSITY EMPLOYEE ID #:_________________

CITATION #:

____________________________________

NAME:

_______________________________________

CITATION DATE:

____________________________________

ADDRESS: _______________________________________

VIOLATION CODE: ____________________________________

CITY:

_______________________________________

LICENSE PLATE #:

____________________________________

E-MAIL: _________________________________

STATE:

____________

ZIP: _____________

Note: notices, including appeal decision, related to this Appeal Form will be sent to

this e-mail address

PHONE #: _____________________________

I wish to appeal this citation for the following reason(s): ________________________________________________

______________________________________________________________________________________________

I certify that the statements made above are complete, true and correct to the best of my knowledge and belief. I understand that the decision of the

Appeal Hearing Officer, based on the appeal process is final without further right of review. Once I receive the appeal decision, if my appeal is denied or

my fine is reduced, I agree to pay the amount due within ten (10) business days after the date the appeal decision is sent to me. If payment is not

received by the Department of Parking and Transportation within the allotted time, a late payment charge of $10.00 will be assessed.

APPELLANT'S SIGNATURE: ______________________________________________

DATE: ___________________________

Submit appeal to Department of Parking and Transportation

*****************************************************************************************************************

THIS AREA IS FOR APPEAL HEARING OFFICER'S USE

APPEAL DECISION:

DENIED

WARNING – NO FINE ISSUED

REDUCED FINE TO $ ___________

DECIDED BY APPEAL HEARING OFFICER: ________________________

DATE: _____________

FINDINGS OF FACT:______________________________________________________________________________

______________________________________________________________________________________________

THIS AREA IS FOR OFFICE USE

APPEAL DATE: _____________

APPEAL #: ____________

ENTERED BY CLERK: ________

Form PT #1

DATE COPY OF APPEAL DECISION SENT TO APPELLANT: _____________

University Issued Parking Citation And Towing / Vehicle Immobilization Appeal Form - Department Of Parking And Transportation

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