Smoking Citation Appeals

Background Information

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Your full name:

Your position/title:

Your phone number:

Your email address:

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Your UIN:

This is your _____ violation.(Required):

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Date of incident(Required):

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Time of incident:

Location of incident(Required):

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Specific location:

Relevant Appeal Information

Please provide us with as much information as possible. One of the appeal conditions is that the smoking citation MUST be paid in full before it can be given formal consideration. Scan a copy of your PROOF OF PAYMENT and submit it below in the "SUPPORTING DOCUMENTS" section.

Citation Number (Top right corner of your smoking citation form)(Required) This field is required.

Please describe your reason(s) for appealing this smoking citation?(Required) This field is required.

Is there anything else you would like the Smoking Citation Appeals Committee to consider? This field is required.

Supporting Documentation

Scan a copy of your PROOF OF PAYMENT and submit it below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Relevant Appeal Information

Supporting Documentation

Submission