Appeals Form
DELTA COLLEGE PARKING APPEAL BOARD UNIVERSITY CENTER, MI 48710 REQUEST FOR APPEAL TO THE PARKING APPEAL BOARD A lost ticket, parking only for a short period, parking in a nearly empty lot, not knowing the regulations and/or not seeing the sign(s) are UNACCEPTABLE GROUNDS FOR APPEAL. Clarity should be the deciding factor in your appeal. You will be notified, by copy of this appeal, of the hearing decision. _____________________________________________________________________________________ (Please print with a pen) College ID # : _____________________________________
Telephone # : ______________________
Name : __________________________________________
Date Appeal Filed : __________________
Street Address : ___________________________________
Date of Ticket : _____________________
City/State/Zip : ____________________________________
Ticket # : _________________________
I wish to request relief from the indicated parking ticket for the following reason(s) : __________________
For additional space continue on the back or use another sheet. Diagrams are strongly recommended.
ATTENTION APPELLANT: DO NOT FILL OUT BELOW THIS LINE
COMMITTEE DECISION :
DISMISS
Section titled “DISMISS”SUSTAIN
Section titled “SUSTAIN”FACULTY
Section titled “FACULTY”ADMINISTRATOR
Section titled “ADMINISTRATOR”STUDENT
Section titled “STUDENT”TO : ___________________________ TICKET # : ___________ DATE OF DECISION : ____________ _______ The charge is dismissed. No fine is due. _______ The charge is sustained. A fine of $_______ is due for the violation. IF NOT PAID WITHIN 21 DAYS, THE FINE WILL DOUBLE AND A $ 2.00 SURCHARGE WILL BE ADDED. NOTE : Fines should be paid in person, by check, or by money order. COMMENTS : _________________________________________________________________________________