Expiation Notice Appeal Form Parking Offences Expiation Number*Vehicle Registration*Full Name* First Surname Date of Birth* Licence NumberResidential Address* Address Line 1 Address Line 2 Suburb State Post Code Is this the same as your Postal Address ?YesNoPostal Address* Address Line 1 Address Line 2 City State Post Code EmailA pdf of your submission will be emailed to this address if entered Enter Email Confirm Email Preferred Phone Contact NumberAre you the registered owner of the above vehicle?*YesNoThe Expiation of Offences Act 1996 and Australian Road Rules include provisions that allow an expiation notice to be withdrawn if certain circumstances exist or the offence could be considered trifling (as defined by the Act). To assist in determining if this expiation notice is able to be withdrawn on appeal, please select YES or NO to the following questions before completing the statement to support your claim. ** Note: Any files you upload must be of type jpg, jpeg, png, pdf or docx Was your vehicle parked in an illegal manner as a result of a direction or instruction from a Police Officer or another Authorised Officer?*NoYes** You must include documented evidence along with your written statement in the section below. You may need to contact Police to obtain this material. Instruction: Documented EvidenceAccepted file types: jpg, jpeg, pdf, txt, docx.Instruction: Written StatementWas your vehicle parked in an illegal manner as a result of a medical or other type of emergency?*NoYes** You must include documented evidence along with your written statement in the section below. The Ambulance Service or Hospital Registrar/GP will be able to provide you with the applicable material. Emergency: Documented EvidencePlease Upload Accepted file types: jpg, jpeg, pdf, txt, docx.Emergency: Written StatementWas your vehicle parked in an illegal manner as a result of a mechanical failure or accident preventing you moving to a legal park?*NoYes** You must include documented evidence of breakdown or accident with your written statement in the section below. Your roadside assistance organisation or attending mechanic will be able to provide you with suitable material. Mechanical/Accident: Documented EvidencePlease Upload Accepted file types: jpg, jpeg, pdf, txt, docx.Mechanical Accident: Written StatementDoes the expiation notice issued to you, contain errors or incorrect information, such as wrong location, vehicle, time or date?*NoYes** Please outline the errors or incorrect information and details of why you believe the information is incorrect, in the written statement section below. Expiation Error: Written StatementWere the signs or road markings relevant to this offence totally obscured or not erected in accordance with Australian Standards?*NoYes** Please provide detail of the non-conforming sign or marking in the written statement section below.. Photographs and diagram will assist with your claim and will be compared to photographs taken at the time of the offence. Photo EvidencePlease upload Accepted file types: jpg, jpeg, pdf, txt, docx.Traffic Information: Written StatementWas your Permit to park in a restricted zone visibly displayed on the passenger side dashboard?*NoYesCouncil will review it's photographic record of the offence. Please give a reason in the section below, why the Permit was not displayed and present the original permit to Council Front Counter or submit a photocopy of the original permit. Copy of your Original PermitPlease Upload Accepted file types: jpg, jpeg, pdf, txt, docx.Permit: Written StatementWere there compelling humanitarian or safety reasons or any other emergency situation existing so that you could not reasonably have avoided committing the offence?NoYes** You must include documented evidence along with your statement in the written statement section below to substantiate your appeal. This could also include evidence that the offence was merely a technical, trivial or petty instance of a breach. Documented EvidencePlease Upload if applicable Accepted file types: jpg, jpeg, pdf, txt, docx.Safety: Written StatementIt is important to note, that offences against the Australian Road Rules regarding parking and stopping are not recorded against a drivers traffic record and do not attract demerit points. Section 15(4) of the Expiation of Offences Act provides that payment of an expiation notice does not constitute an admission of guilt or civil liability. Section 11(1) of the Expiation of Offences Act 1996 provides that a reminder fee may be added to the unpaid expiation fee if an appeal is unsuccessful and the fee has not peen paid by the due date. General Statement to explain/support claimFollowing the receipt of this Expiation Appeal, the Notice will be put ‘on hold’. Your application will be assessed and you will receive written notification of the decision. The notification will include a payment due date if applicable. If the expiation notice is cancelled, you will receive notification and there will be no further action taken. Applicant Signature*Date* CAPTCHANameThis field is for validation purposes and should be left unchanged.