2. Parking Citation Number *
4. Date Citation Issued*
   Date Citation Issued
6. Plate/VIN Number*
10. Your Full Name (Last, First, Middle)*
12. Your Street Address, City, State, Zip*
14. Your Date of Birth*
    Your Date of Birth
16. Your Driver's License Number*
18. Your Telephone Number*
22. Registered Owner's Name (if different than above)*
24. Registered Owner's Date of Birth*
    Registered Owner's Date of Birth
26. Date of Request/Today's Date*
    Date of Request/Today's Date

    Date of Request/Today's Date
30. Important Information

    All requests to contest a parking citation MUST be made within 14 days of the date the parking citation was issued: there will be no exceptions granted.

32. To avoid a late fee, you must contest a parking citation within 14 days of the date the citation was issued. Late Fee Schedule Information is located on the front of your citation.
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field