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Apply for the review of a Penalty infringement notice

The requested information is necessary to investigate your circumstances so please ensure the information provided by you is true and correct in every respect.

Penalty infringement number:

Vehicle / animal registration number:

Date the ticket was issued:

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Your name:

Your email:

Your postal address:

Notification of the outcome of your appeal will be sent to the postal address you provide prior to any further action being taken.

Provide the circumstances which led to you being issued with a Penalty infringement notice:

Terms:

I hereby declare that the information provided on this form is true and correct in every respect.

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Aboriginal and Torres Strait Islander flags

We Acknowledge the Wadawurrung People as the Traditional Owners of the Land, Waterways and Skies. We pay our respects to their Elders, past, present and emerging. We Acknowledge all Aboriginal and Torres Strait Islander people who are part of our Greater Geelong community today.