Ticket Appeal Form

Note: Traffic citations are automatically placed on your student account. Please do not pay the fine until you have been notified of the outcome of your appeal. If approved, the fine will be removed from your account. If denied, payment will be due upon notification.

All fields are required.

Date (mm/dd/yy):	A value is required.Invalid format.
Name:	A value is required.
E-Mail:	A value is required.Invalid format.
Campus P.O. Box:	A value is required.
Student ID #:	A value is required.
Violation # (see back of ticket for violation code number): A value is required.
Ticket #:	A value is required.
Infraction Date (the date the ticket was written): A value is required.Invalid format.
Infraction Time	A value is required.
Officer #	A value is required.
Infraction Location:	A value is required.
Please state the reason(s) for your ticket appeal. DO NOT include your name in this text box: A value is required.
Supporting documentationfor your appeal may be submitted as follows: after submitting this appeal form, forward the documentation along with your name and ticket # to Box 549006 via campus mail.
Please make a selection.I understand that I am bound by the BSC Honor Code and that my statements in this appeal are truthful.