Parking Citation Appeal Form

Name:

Email Address:

Home/Campus Address:

City, State & Zip Code:

Campus/Home Phone Number:

License Plate Number:

State of Registration:

Date/Time of Violation:

Vehicle Make/Year:

Ticket Number:

Violation Number:

Lot/Location:

Appellant Statement:
Please provide a statement, in the text box below, regarding why you believe this citation was issued in error, or why you should be excused from the responsibility for payment of this citation.