Name:
Address:
Telephone:
E-mail:
Patron ID:

Ticket Information and Reason for Appeal:

Ticket Number:
Ticket Date:
YSU Permit Number, include the letter prefix:
License Plate #:
License State:
Lot Number:

Status: Please indicate in box provided if you have a valid YSU parking permit and the type of permit you have (i.e. Contracted Services, Contractor/Vendor, Faculty/Staff, Guest Permit, Student) or if you are a Visitor to campus.


Reason for Appeal: