Parking Ticket Appeal Form

2. Parking Clerk
   Town Hall
   41 Highland Avenue
   Cohasset, MA 02025
4. To Whom It May Concern,
6. I Hereby Wish to Appeal Ticket Number:
7. Issued on:
   (Date)
9. For:
   (Violation Code or Violation Type)
10. On Vehicle Registration Number:
12. My Reason for Appealing is as Follows:
14. Signature
15. Upload A copy or a Photo of your ticket*
    In order to process your appeal, the Parking Clerk needs a photo or a scan of your ticket.
17. Name
    (Type or Print)
19. Address
21. City
22. State
23. Zip Code
25. Home Phone
26. Cell Phone
28. Date of Appeal Filing
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field