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:

Please provide the penalty infringement number

Vehicle / animal registration number:

Please provide your vehicle / animal registration number

Date the ticket was issued:

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Please provide the ticket issue date

Your name:

Please provide your name

Your email:

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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.

Please provide your postal address

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

Please provide the circumstances

Attached additional information:

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

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

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Apply for the review of a Penalty infringement notice