Leave no field blank if the requested information exists.
Name
Local Address 1
Local Address 2
City, State & Zip
Phone Number
Social Security # or Student ID
E-mail Address
Status (check one)
If Other, please specify:
Please enter the information from your Traffic Citation in the fields below. Any deviation or omission of any field could cause a delay in your appeal. Use the diagram to determine the required information is entered in the correct location.
Citation Number
License Number
License Year
License State
Date & Time
Permit Type
Permit Number
Officer
Make/Color/Style
Violation Code
Location
Officer's Comment
Required: TO BE COMPLETED BY APPELLANT: In the space provided, state the reasons why you believe this citation is improper or invalid. Be specific and include as much detail as possible.
TRAFFIC APPEAL PROCEDURES AND REGULATIONS
Please read the Traffic Appeal Procedures and Regulations before continuing. By clicking the box labeled "I ACCEPT" below, you are electronically signing the form. You may click the "Police Home" button below to return to the University Police Home Page.
I hereby certify that the information I have provided is true and correct. I also understand that any statements made on this form are subject to the WFU Honor Code and may result in campus judicial action.
You will receive notification of your appeal outcome at the email address provided above.
PRIVACY POLICY: This is a secure form - all submissions are encrypted in transit. Wake Forest does not use the information for other than its intended purpose. It is neither distributed nor sold.