Parking Citation Appeal Form - Excel by qfa20129


									                                                                                Complete this form. SAVE and then send as an
                                                                                email attachment to the address, below.

Campus Safety                                                                   PARKING CITATION APPEAL FORM
PO Box 98000 / 2400 S. 240th Street                                                                                   (206) 878-3710 ext. 3218
Des Moines, WA 98198-9800                                                                                                  (206) 870-4836 fax

 PLEASE READ: The following are unacceptable grounds for appeal: lost citation, forgetfulness, parking only for a
 short period of time, failure to display a valid parking permit, failure to see signs, giving incorrect or invalid
 information (e.g. wrong license or permit number). Appeals submitted for these reasons will be DENIED. Appeals
 must be submitted within twenty (20) days of citation issue date to be considered. State the nature of the appeal and
 provide specific reasons and basis for your appeal. Submit completed appeal via email to This form will be returned to you via email within fifteen (15) business days with a
 decision indicated in the Action Taken box, below. See below for further appeal options.

Name:                                                           ID #: 880-                                 Date:
                                 Address                                City                       State                   Zip

Valid Email Address:                                                                          Status:         Select One
Permit #:                              License Plate #:                                 Vehicle Make/Model:
Telephone #:                                              Citation #:                         Date citation issued:

Nature of Appeal:

I hereby certify that the above is a true and accurate statement of my appeal.
                                                                                                   Type Name
ACTION TAKEN: (For Safety Office Use Only )

1st Review by:                               2nd Review by:
                      initials                                  Safety Supervisor, R. Noyer                        Date

 If you are dissatisfied with the Action Taken, above, you may appeal to the Office of the Vice President for
 Student Services. Submit this completed form, including Action Taken to You
 will receive an email response in approximatley 3 weeks. If you are dissatisfied with the decision of the Office
 of the Vice President for Student Services, you may appeal to the King County Superior Court (WAC 132I-116-


To top