Parking Enforcement Citation Appeal Form

Parking Enforcement Citation Appeal Form

For Parking Citation and Handicap Parking Citation Appeals
Owner/Operator's Name*

First NameMiddle NameLast Name
Address*

Street Address

Apartment/Suite #

CityState

Zip Code
Home*

AreaPhone Number
Mobile*

Area Phone Number
Work*

AreaPhone Number
Email*
example@example.com
Citation Number*
Citation Issue Date*

MonthDayYear
Date
Parking CitationHandicap Parking Citation
FOR HANDICAP APPEALS ONLY
Required proof for submitting Handicap Citation Appeal Form online or in person:
1. APPEALS MUST BE SUBMITTED/FILED WITHIN TEN (10) DAYS OF ISSUE DATE
2. COPY OF HANDICAPPED PLACARD
3. COPY OF DRIVER'S LICENSE OR IDENTIFICATION OF THE PERSON THE PLACARD IS REGISTERED TO
4. COPY OF TICKET
5. IF VEHICLE IS REGISTERED TO SOMEONE OTHER THAN HANDICAPPED PERSON, PLEASE SUBMIT PROOF HANDICAPPED PERSON HAD BEEN IN VEHICLE AT THE TIME THE TICKET WAS ISSUED.
6. IF HANDICAPPED PLACARD IS OUT OF STATE, SUBMIT A COPY OF THE HANDICAPPED PLACARD REGISTRATION.
Required: Upload Copy of Handicapped Placard. (NOTE: if the placard is OUT of STATE include a copy of the Handicapped placard registration)*

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Required: Upload Copy of Driver's License or Identification of Person the Placard is Registered to*

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YesNo
ONLY APPLICABLE TO YOUR APPEAL IF the vehicle is registered to someone other than the handicapped person. Please upload proof handicapped person had been in vehicle at the time the ticket was issued.*

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Required Upload Copy of Parking Citation Ticket*

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Location of Violation Give specific address and closest intersection*
Reason for requesting dismissal*
Terms & Conditions

By checking the box below, you agree that:
1. You have read, understand and accept these Terms & Conditions ("City of Greensboro Terms and Conditions");
2. This constitutes your signature under any applicable law or regulation;
3. You have read and understand the Terms and Conditions and the Privacy Policy for www.greensboro-nc.gov (the "Website"), which are incorporated into these Terms and Conditions;
4. You authorize the City’s Transportation Department and its managers, lawyers, directors, employees and representatives to make any inquiries necessary to investigate any dispute relating to your use of this Online Request Service (the "Service").
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