Please complete this form if you are requesting an Administrative Hearing . Administrative Hearings may be scheduled by written appeal only. If you are contesting more than one parking citation , you must complete a separate form for each parking ticket. Administrative Hearing Requests must be returned to the Department of Public Safety 21 days from the date on your initial review request outcome notice. Administrative Hearings will not be scheduled if full payment of your parking citation is not paid before your request. Administrative Hearings will not be scheduled if an Initial Review has not been conducted.
I hereby request an Administrative Hearing by Written Appeal. I understand that my Initial Review statement will be used by the Hearing Officer to make a decision in lieu of in-person testimony.
*Date of Initial Review
*Date of Violation
*Vehicle Parking Permit No.
*License Plate Number
*Student ID #
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