Department of Public Safety
Parking Traffic Appeal Form
Ticket Information:
Ticket #: ___________ SHU ID Number: __________
Decal Classification: ___________ Decal #: __________
State of Registration: ___________ Registration#: __________
Date of Violation: ___________ Violation#(s): __________
Owner Information:
Vehicle Owner's Name: ___________ SHU Student? Yes____ No____
Campus Address: (if applicable):___________ Phone Number: _____________
Local Address: ___________________________________
Email Address: ____________________
Operator Information:
Operator of Vehicle Name: ___________________
Campus Address: (if applicable):________________
Local Address: ____________________
Email Address: ____________________
Reason For Appeal
(Brief Facts Only)