Ticket Appeal Form

Pellissippi State Safety & Security

In case of emergency please call: 694-6649

Name
Address
City State Zip
Phone #
Status: Current student
Past student
Faculty/Staff
Non student
Date Ticket Issued
Ticket #
Location
License plate #
Date appeal sent to Pellissippi State Safety & Security
Hang Tag # (if applicable)
Will you attend the appeal hearing?
E-mail (so we can let you know if your ticket has been voided) Please read instructions before writing your appeal Type on this appeal form your reasons for appealing the citation. As it is expected that citations must be appealed within 14 days of the issue date, if this appeal is late you must also explain why you are appealing after this period of time. ALL APPEAL COMMITTEE DECISIONS ARE FINAL

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