Faculty/Staff Traffic Appeals Form

Faculty/Staff Traffic Appeals Form

1. Tickets are accepted for appeal only if they are received within 14 calendar days of the date issued.
2. All information must be completed for the appeal to be considered.

Vehicle Registration Information
(Please enter information about the vehicle you have registered with Public Safety)

Full Name:
ID#:
Phone Number:
Email Address:
Parking Tag #:
Campus Address:
License Plate # Registered with Public Safety:
State of Registration:
Explanation of Appeal by Faculty/Staff Member:

Ticket Information
(All fields required to be considered for appeal)

Ticket #:
Officer #:
Date of Issuance:
Time of Issuance:
License Plate #:
State:
Permit/Tag #:
Make of Vehicle:
Model of Vehicle:
Color of Vehicle:
Location:
Violation
Dollars Owed:
Date Submitted: