IN THE COUNTY COURT IN AND FOR MIAML-DADE COUNTY, FLORIDA PARKING VIOLATIONS BUREAU REQUEST FOR COURT HEARING ‘REQUEST DA‘ COMPLAINT NO. ‘Thereby contest the above numbered parking complaint and request a hearing on the matter, IHEREBY ACKNOWLEDGE that I, 1 registered owner of the vehicle described in the parking complaint, 1 person named in an affidavit by the registered vehicle owner as having the care, custody and control of the vehi the owner's permission at the time of the violation (affidavit attached), and that I have appeared on the above date for administrative review of the above referenced parking complaint and have been advised that I may pay the civil penelties due or request a court hearing to contest the violation. ‘The factual basis for contesting this complaint is as follows: (Gane ak of Wi om yma need more oom To we) TAM AWARE that by requesting a hearing: + Ishall be deemed to have waived my right fo pay the civil penalty provisions ofthe parking tickét, [Plorida Statute 316.1967) * The Court hearing will be scheduled at Parking Violations Bureau, 22 N.W. 1" Street, 4 Floor, unless otherwise dicated on the Notice to Appear (bring any evidence/proof you wish to present at time of trial + Ifl.am found guilty, the court may impose additional penalties and court costs [Florida Statute 318.14(S), and require payment atthe time of the hearing, ‘+ _If1 fail to appear, the official may proceed withthe hearing and may impose a penelty as if Thad attended the hearing [Rule 6.450(g) F.R.C.}, and may result in * (with BOND posted) payment of the penalty from any bond posted for my appearance at the hearing, + (without BOND posted) the penalty due by the date provided by the notice of my failure to appeer. Notice of the Court Date will be Mailed. You must report any change of your address, ‘ Signature Print Name ‘Address “Aptit (Requestor advised to bring Driver's License to Court Hearing ciy Site ‘ZIP Code Phone Number Payment and cae infomation including hing date ae available 24 hours a deyseven daye a week on the Clerk of Couts website wontiiamdadeclerk com or onthe aufomated sytem by calling 305-215-193, 1 Please note: Advise the Parking Violations Bureau ifyou receive any notice of payment due for he parking compat contested above after making this tequet for hearing OFFICE USE: Branch Office Location: Entered in Computer by: ‘Date: Entered in PC by: _ : Date: Deputy Clerk's Name:__ ‘LWT. 382 Revoens Clec’s web address: ww mlar-dedacerk.com