Parking Citation Adjudication Request

PARKING CITATION ADJUDICATION REQUEST

To contest a parking citation and request adjudication online, you must provide the required information below and signify that you understand and agree to the terms of adjudication. Your completed form will be forwarded to the City of Alexandria Adjudication Office, where an adjudicator will review your case. If the adjudicator needs more information, he or she will contact you by . The results of the adjudicator’s review will be forwarded to you by mail.

To obtain information or pay a parking citation by telephone, please call 866-353-0454. You may also pay a parking citation online by eCheck or credit card.

Citation Number :

Date of Citation :

- - (mm-dd-yy)

Vehicle License Plate :

Vehicle License Plate State :

First Name :

Last Name:

Street Address :

City :

State :

Zip :

Daytime Telephone :

E-mail Address:

Driver's License Number:

Driver's License State :

	I understand that only the registered owner of the vehicle receiving this citation may contest the violation and confirm that I am the registered owner of the vehicle issued this citation.

	I understand and agree that if a determination of guilt is made, or the citation is changed to a lower penalty or offense, a $10 adjudication fee will be added to the violation amount.

Reason for Request :

Attach File :

NOTE: jpg, gif, bmp, png, tiff , txt, doc, wpd, pdf or rtf file extensions are allowed and file size less than 10MB