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Traffic and Parking Violation Citation Appeal

Instructions:

  1. This appeal form must be completed in full and submitted (either in person or via internet) to the Department of Campus Safety and within (5) five business days from the date the citation was issued.
  2. Print form and attach a copy of citation you are appealing. If filing via internet you do not need to attach a copy of citation (it will be attached by the Traffic Board Secretary).
  3. Be as detailed as possible about your appeal as this will be the only information the Traffic Board will have to review.
  4. If the form is not completed properly, the Traffic Appeal Board may discard and return your appeal to you.

DECISIONS MADE BY THE TRAFFIC BOARD ARE FINAL

Fields in RED cannot be blank. If you are a UT student, faculty or staff person, you MUST complete the entire form. Incomplete forms will not be reviewed. 

Date:   [None] Select a Date Delete the Date
 
Ticket Number:   
Name (First and Last):   
UT ID Number
(students, faculty and staff only): 		  
UT Box:     
Email:   
Phone:   
Local Address
(or Residence Hall):  		  
City:   
Zip:    
Vehicle Information 
 Year:    
Make:   
Model:    
License Plate Number:   
State:    
UT Parking Decal Number
(if applicable):  		  

Reason for Appeal: