J. Sargeant Reynolds Community College
Parking Appeals Committee
"RIGHT OF APPEAL" APPLICATION
(An application must be filed for each citation.)
 
The "Right of Appeal" Application must be filed within a period of fifteen (15) business days, inclusive of the date on which the citation was written.
 
This form may be filed electronically by clicking on the “Submit” button or may be printed and delivered to any JSRCC Department of Police c/o Parking Appeal.
 
Complete application entirely. Failure to complete as requested will result in the appeal not being heard and appeal will be denied.
 
 APPEAL OF PARKING CITATION#:       DATE ISSUED:  Pick a date (mm/dd/yyyy)     DECAL#  
                                                                                                                                                                No Decal
 
 DECAL TYPE:     FACULTY     STAFF     STUDENT     VISITOR
 
 ID#:         Social Security #:  (no dashes)     Drivers License Number #:  (no dashes)     Date Of Birth:  Pick a date
 Name:
 License Plate No.       State of Registration  
 
 Street Address:   
 City:                        State:      Zip:  
 Telephone:           (###-###-####)    Alternate Phone:   (###-###-####)
 E-mail Address:   (if student, please use VCCS email address)     Alternate Email Address:  
 
 I REQUEST A REVIEW OF THE ABOVE REFERENCED CITATION FOR THE REASON STATED BELOW. I ALSO UNDERSTAND THAT I HAVE THE OPTION TO APPEAR ON MY BEHALF OR HAVE THE APPEAL REVIEWED IN MY ABSENCE.
 
  I CERTIFY THAT THE ABOVE STATEMENT IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
(checking this box implies your signature on the appeal application)
 
    WILL APPEAR AS MY CORROBORATING WITNESS
 
____________________________________________________________________________________________________________________

For Parking Appeals Panel Use Only
 
   *Appeal Denied, Failure to file within prescribed time   Appeal Denied, Fine Imposed $_________
 
   *Appeal Denied, Failure to appear (No Show)            Appeal Granted            Waive Late Fees
   
 
____________________________________________________             ____/_____/____
                                               Chairperson                                                             Date
 
*Failure to file an appeal application within prescribed time, failure to appear on scheduled appeals date without timely notification and failure to complete this form in its entirety are grounds for automatic appeal denial.

       

JSR Form 70-0045   Revised 7/12/2011