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CAMPUS POLICE

Citation Appeal Form

Please provide detailed information and if applicable, your handicapped permit number. Citation and officer numbers can be found on the citation you received. (Fields marked with * are required)

Email:*

First Name:*

Last Name:*

Address:*

City:*

State:*

Zip:*

Phone Number:*

Citation Number:*

Date of Violation:*

Location of Violation: *

Vehicle License Plate: *

Vehicle Make/Model: *

Handicapped Permit Number (if applicable):

I am primarily: * Student Faculty/Staff Visitor/Other

If you have selected Other, please specify:

Reason(s) for Appeal: *

I submit the following facts and circumstances in support of this appeal. I have read all of the rules and regulations for parking at Lakeland and the appeal process. All information provided is the absolute truth.

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