| Date of Violation: |
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| Time of Violation: (24:00): |
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| Name: (last,first) |
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| Email Address: |
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| Phone Number: |
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| Parking Permit Number: |
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| (**NOTE: No appeals will be granted unless the vehicle is registered with the NNU Dept. of Security. To register your vehicle and obtain a parking permit, contact NNU Security**) |
| Vehicle License Plate Number: |
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State of License Plate: | |
| Violation Number (located in the upper right corner of ticket): |
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| Location of Violation: |
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Reason for Citation:
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| Other reason: |
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In the space provided below, please justify your reasoning for wanting an appeal. Be as specific as possible,
and make note of any extenuating circumstances that will help your argument.
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