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2. Name*
3. Ticket Number*
5. Street*
6. Date Issued*
8. City*
9. State/Plate #*
11. State*
12. Phone Number
14. Zip*
15. Email
17. Preferred Response*

    1. email
    2. USPO
19. Name of Vehicle Owner*
21. Street*
23. City*
25. State*
27. Zip*
29. Please type or write CLEARLY your reasons for appeal and submit all supporting documents.*
31. Supporting Document Upload 1
32. Supporting Document Upload 2
34. I affirm that all the above information is true and correct to the best of my knowledge. I acknowledge that the Town of Amherst may deny my appeal due to lateness if not received by the Parking Clerk’s Office before the payment due date (21 days from date of issue).
36. Date*
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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field