Road Fine Appeal Letter
About this Appeal
Who is Sender?
Fine Details
Miscellaneous
Complete the Document
Format & Signatures
Who is Sender?
Indicate full name of a person submitting this appeal (Sender):
Provide contact phone number of the sender:
Provide the vehicle’s VIN number for which the fine was issued:
Provide the penalty notice or ticket number assigned to the sender’s road fine:
Select the date on which this letter is being sent:
Fine Details
Select the date on which the fine was issued:
Select the reason why the fine was issued:
speed matter
parking matter
other matters
Briefly describe the reason fine was issued:
Describe in detail the circumstances surrounding the speeding offence:
Describe in detail circumstances that led to the offence:
Does the fine notice that that the sender was in breach of the parking rules?
No
Yes
Describe in detail how the vehicle was parked:
Does the sender wants to attach evidence in support of this claim?
No
Yes
Select the reason on which the sender is challenging the fine:
signage does not clearly set out the parking restrictions
vehicle was parked at the other location
other circumstances
Provide full details of the location where the vehicle was parked:
Describe all mitigating circumstances that the sender believes should lead to the fine being waived:
Miscellaneous
Indicate the amount of the fine, in Australian dollars:
Indicate full name of a local authority, city council or private parking operator that issued the fine:
Provide the recipient's mailing address:
Do you want to add a signature?
Yes
No
Sender's signature:
Save signature
Clean
Edit signature
Select a template's format:
PDF
DOCX
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