HomeMy WebLinkAboutBylaw Ticket Dispute Form.pdf
City of Maple Ridge Bylaw Ticket Dispute
***This Does Not Guarantee the Ticket Will Be Re-Assessed***
City of Maple Ridge Date: August 2016
11960 Haney Place, Maple Ridge, BC V2X 6A9 Tel: 604-467-7305 Fax: 604-467-7445
Web Site: www.mapleridge.ca Inquiries: licencesandbylaws@mapleridge.ca
I dispute the charges indicated within the following Bylaw Ticket
Ticket #:
Date of Offence:
I am over eighteen (18) years of age (please circle one): Yes No
I am the Registered Owner of the vehicle (please circle one): Yes No
Licence Plate/T.O.P Number:
Location of Offence:
Outstanding Fine Amount:
Name (please print):
Address:
Daytime phone #: Evening phone #:
For the Provincial court to provide you with notice of your hearing date, it is important that a complete
mailing address and telephone number are provided.
Details of Dispute:
Signature Date