Penalty notice review form

A request for review is required to be submitted within SEVEN days of receiving penalty notices. The review will be completed for possible errors or omissions. To contest the charge that may be filed at a later date in Provincial Court, please await formal documents including a summons to court.

Name

Mailing Address

City/Town

Province

Postal Code

Country

Office / Work Phone No.

Home Phone No.

Date Ticket Issued

Ticket No.

Vehicle License No.

Street Location

Reason for Request to Review

Details or Complaint Information

I agree that all of the information I've provided in this form is accurate. I understand that the contents of this application may be reviewed by Town of Riverview employees and that the contents of this application will be subject to the Town of Riverview's information policies.