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CITATION REVIEW REQUEST
NAME
*
CONTACT NUMBER
*
EMAIL ADDRESS
*
CITATION NUMBER
*
LOCATION THE CITATION WAS ISSUED
*
The submission of this form
does not
excuse the fine nor extend the fine due date; however, should the citation be excused through the formal process, the fine will be returned.
-
I understand the above statement.
*
TODAY'S DATE
*
+
Explain the reasons you wish the citation to be considered to be excused. Include all pertinent facts and attach a photo of the citation.
*
***UPLOAD A PHOTO OF THE CITATION ONLY***
*****DO NOT INCLUDE PHOTOS OF SCENE*****
UPLOAD A PHOTO OF THE CITATION
*
Your request will follow a defined process through Administration and members of the ORCA Board and Public Safety Committee, and therefore may take time for any resolution.
SIGNATURE
*
clear
Form ORCAPSD 051, Rev. 5/24