Request for Parking Hearing Review

If you are asking for a hearing request, you must have already participated in a review Screening. If you are not in agreement with the results of the screening you may request a Hearing by filling out the form below.

Ticket Information

Ticket Number	*
Plate Number	*

Registered Owner Information

Name	*
E-Mail	*
Phone	*
Address, City, Postal Code	*

I acknowledge that the Town of Innisfils Screening Officer will rely on the information provided in this form to confirm vehicle ownership.

Check if The Applicant Information is different from the Owner Information above
IMPORTANT if you are not the registered owner of the vehicle, please complete the Authorization to Act Form. The registered owner must authorize you to request a review of the penalty notice.

Violation and screening Information

Date Penalty Notice Issued	*
Date Screening Review Requested	*	(A review Screening must take place before a hearing)
Select those that Apply		An extension of time to request a hearing review as more than 30 days and fewer than 60 days have passed since the decision of the screening officer A review of the decision of the screening officer in its entirety A review of the decision of the screening officer with respect to the amount of the administrative penalty and/or administrative fees A review of the decision of the screening officer with respect to the time to pay the administrative penalty and/or administrative fees
Reason for Requesting Hearing	*
		Please acknowledge that you understand all hearings will be in English, and if you require an interpreter, you are responsible for providing your own. I am comfortable speaking English. I will be bringing an interpreter.
		By checking this checkbox, I certify that all information provided in this application is true and accurate. I will notify the town if any of the information changes before the hearing date.