Vehicle Violation Appeal Form

Last Name:
First Name:
E-mail address:
Student, staff, or faculty?
If you are staff or faculty:
Phone extension:  

If you are a student:
Student ID:  
Campus Phone:  
Cell phone:
Do you live on campus? Yes     No
Residence hall:

Have you registered a vehicle previous to the one currently
 Yes     No
Violation notice number (located on upper right corner of
violation notice):
Date of violation issued (mm/dd/yyyy): / /
Time of violation issued (hh:mm): AM  PM
Parking decal number (If you are registered with Safety, it will
be located on your car window and noted on the violation):
 No parking decal
I am appealing my vehicle violation notice for review based on the following reason(s):

 I wish to appeal the above violation

All appeals need to be submitted within 5 business days from the date of the violation.
Appeals will be processed on a bi-weekly basis.

Note: You will be notified via e-mail when the review is completed.