By submitting the above information, I acknowledge that:
This is an administrative review and I do not have to appear in court. This form and explanation
is reviewed independently by Police Department personnel.
If the administrative review is denied, I am obligated to pay the base fine within seven (7) days
of written notice of denial. If not paid in the seven (7) days, late fees will begin to accrue.
I will only be notified, in writing, if the appeal is denied.
