Untitled Document

Date

GEORGE MASON UNIVERSITY

PARKING SERVICES APPEAL

Student F/S Visitor

(NO APPEAL WILL BE PROCESS WITHOUT FULL INFORMATION)
Do not appeal a ticket that is not yours (You will be responsible for the vehicle and future tickets)

Citation # Issue Date Lic. Plate # State

Name G #

Mailing Address Driver Lic #

City State Zip Code

Home Telephone # Work/Cell Telephone #

Briefly (but fully) summarize the facts on which you base your appeal.

Remarks:

For Office Use Only

Appeal Approved: _________

Appeal Denied: ________

Appeal Downgraded: ________

Amount Due: ________________

Remarks: _______________________________

_______________________________________

Appeal Officer: _______ Date: ______

(Citation must be attached to the Appeal Form)

APPEAL AGREEMENT

I am appealing this citation for the reason (s) explicitly stated on this form, and my signature below acknowledges an understanding of the following:

As stated in the George Mason University rules and regulation, the decision of the Appeals Review Board may be final.
That an Appeals Officer, who is not affiliated with Parking Services, will approve deny, or downgrade my appeal based on GMU Parking Services records, rules and regulations and upon the information provided hereon.

I also understand that if I do not receive a written notification (by post mail) of my appeal decision within the allotted five (5) days of my appeal’s date, I will contact GMU Parking Services to verify the decision.

That on base of my appeal decision: Denied or Downgraded by the Appeals Officer I may be able to request a hearing date with the next coming Parking Appeals Review Board or pay the ticket (s) within ten (10) calendar days from the appeal’s date. After ten (10) calendar days $10.00 or up to $20.00 late fees will apply and my account will be on hold including any accrued late or returned check fees.

NOTICE

George Mason University adheres to the regulations of the Commonwealth of Virginia. We refer account delinquencies to a collection agency, the Department of Taxation, Division of Set off Debt Collection, and report to a Credit Bureau. If your account remains unpaid, you are responsible for any additional fees added to your account. Collection costs may be as much as one third of the balance due referred by the University.

I certify that the information I have provided in this appeal is true. I understand that if found not to be true, I may be subject to penalties under University disciplinary regulations.

Signature Date