26 Shankpainter Road

Provincetown, Ma 02657

Tel: 508-487-7050 Email: parkingadm@provincetown-ma.gov

PARKING VIOLATION HEARING REQUEST

Pursuant to Massachusetts General Las Chapter 90, Section 20A ½, I am requesting a hearing before the Town of Provincetown Hearing Officer. (Hearing request must be filed and received in the Parking/Police Department within twenty-one (21) days of the issue date of the citation.)

DATE: TIME: TICKET NUMBER:

DATE OF TICKET ISSUE: STATE & PLATE NUMBER:

STREET LOCATION: VIOLATION:

METER #: AMOUNT OF TIME PAID FOR:

TIME PARKED AT METER RETURNED TO VEHICLE # OF QUARTERS

PURSUANT TO MGL CHAPTER 90 SECTION 20A ALL HEARINGS ARE BY MAIL

The Hearing Officer will require a complete written description of your complaint, the circumstances of the ticket issuance and any other information pertaining to the citation in question. You may submit this information in the space provided below. The Hearing Officer will review your statement and that of the issuing officer, and you will receive a written decision with 21 days of the receipt of the request. Please note that a hearing does not stay additional penalties from being added to this citation if the Hearing Officer finds the case against the registrant. The Hearing Officer’s decision is final, with appeal only through District Court.

COMPLAINT/HEARING INFORMATION: (Use reverse side if More Space Needed)

NAME

STREET CITY STATE ZIP

TEL: DAY NIGHT EMAIL