Skip to Main Content
Business
Residents
Visitors & Events
Government
Search
Home
Form Center
Form Center
Search Forms by:
Enter Search Terms
Select a Category
Select category/categories to filter
All Categories
Art CAN Help
Art in the Burg Artists Application Form
Artists in Middleburg Liability Form
Business License
Employment
Farmer's Market
Health Center Fund
Loan of Art - Display in Town Hall
Middleburg Citizens Academy
Middleburg Special Event Funding Request
Oktoberfest Artists Application Form
Oktoberfest Liability & Waiver Form
Online Forms
Parking
Police Department
Rental Applications - Town Hall Meeting Rooms
Requested Boundary Line Adjustments
Social Media Request Form
Special Event Permit
Town Council
Town Grants
Training Category
Utilities
Wellness Day
Search
By
signing in or creating an account
, some fields will auto-populate with your information.
Parking Ticket Appeal Request
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Middleburg Police Department
Parking Ticket Appeal Request
Requested By:
*
Contact #
*
Email Address
*
Date of Request
License Plate Number
*
Ticket #
Date Issued
Violation
*
Reason the ticket is being appealed
*
Upload picture
Results of the request for to appeal:
LEAVE BLANK OFFICIAL USE ONLY
Chief's response
Disposition:
Approved / Denied
Chief/designee signature:
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
* indicates a required field
Payments
Keep Me Informed
Parking
Business Directory
Public Meetings Video
Special Events
Government Websites by
CivicPlus®
Loading
Loading
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow