FRESNO STATE POLICE DEPARTMENT
TRAFFIC OPERATIONS
2311 E Barstow Ave, M/S PO14
Fresno, CA 93740
(559) 278-2950
(559) 278-7538 (fax)
REQUEST FOR ADMINISTRATIVE REVIEW
OF PARKING CITATION
● Requests for Administrative Review of a parking citation are not accepted beyond the due date of the citation.
● Appeal results are mailed to the address the Department of Motor Vehicles has on file.
● Traffic Operations is not responsible for address changes.
● This form must be filled out completely and legibly to be processed, *required, **required if applicable
FIRST
REGISTERED OWNER (R/O)
FRESNO STATE ID**
LAST
ADDRESS
PHONE NUMBER*
CITY
CIRCLE ONE:
FIRST
STATE
ZIP
DRIVER INFORMATION, IF NOT R/0
DRIVER (borrowed vehicle) / LEASED VEHICLE / RENTAL CAR
LAST
FRESNO STATE ID**
PHONE NUMBER**
ADDRESS
CITY
STATE
CITATION INFORMATION
VEHICLE LICENSE PLATE NUMBER
CITATION NUMBER
ZIP
DATE ISSUED
EVIDENCE
Please state the facts below showing factual evidence of an invalid citation:
This statement is true and correct:
AR
LIABLE
AM
AL
(signature)
OFFICE USE ONLY
INITIALS
NIS
NOT
LIABLE
97
NOT
LIABLE
(date)
DATE
98
NOT
LIABLE
COMMENTS
REVIEWED BY
901 11/2015
DATE
CODE INPUT BY
DATE
99