*Last Name:           *First Name:          

*Local Address:          

*City:           *Zip:          

*Home Phone:           Work Phone:

*MWSU ID # :           *Email:          

*Vehicle License/State:           Sticker #:          

*Citation #:           *Date Issued:           *Time Issued:          

*Officer #:           *Offense Location:          

*Reason for Appeal:
 

A $10.00 ADMINISTRATIVE APPEAL FEE MAY BE ADDED TO YOUR PARKING FINE FOR ALL APPEALS THAT ARE UPHELD BY THE TRAFFIC APPEALS BOARD.

You will receive a confirmation receipt of your Appeal Form by email.

Your confirmation receipt will include your Appeal Hearing date and time.

By clicking "Submit", I understand that there is a possible $10.00 per citation fee for all upheld citations.