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ticket appeal form

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.

Date:
Name:
E-Mail:
Campus P.O. Box:
Student ID #:
Violation # (see back of ticket for violation code number):
Ticket #:
Infraction Date (the date the ticket was written):
Infraction Time
Officer #
Infraction Location:
Please state the reason(s) for your ticket appeal:
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.
I understand that I am bound by the BSC Honor Code and that my statements in this appeal are truthful.