Skip to Main Content
Loading
Loading
Operations Notice
Parking and Access Impacts at Town Office
Read On...
Business
Residents
Visitors & Events
Government
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Art CAN Help
Art in the Burg Artists Application Form
Artists in Middleburg Liability Form
Business License
Employment
Farmer's Market
Health Center Fund
Middleburg Special Event Funding Request
Oktoberfest Artists Application Form
Oktoberfest Liability & Waiver Form
Online Forms
Parking
Police Department
Requested Boundary Line Adjustments
Social Media Request Form
Town Council
Town Grants
Training Category
Utilities
Wellness Day
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Parking Ticket Appeal Request
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Middleburg Police Department
Parking Ticket Appeal Request
Requested By:
Contact #
Email Address
Date of Request
Ticket #
Date Issued
Violation
Reason the ticket is being appealed
Upload picture
Results of the request for to appeal:
LEAVE BLANK OFFICIAL USE ONLY
Chief's response
Disposition:
Approved / Denied
Chief/designee signature:
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
* indicates a required field
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow
