Request for a Screening Review

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Request for a Screening Review

The Town of Tecumseh issues Penalty Notices (parking and by-law "tickets") for various infractions under the Administrative Monetary Penalty System ("AMPS").

If you have received a Penalty Notice/ticket, you may request, by completing and submitting this form, a review of the penalties by a Screening Officer.

This form must be submitted within 15 days of the "Date of Issue" stated on the Penalty Notice. If you require more time and believe you have a valid reason, please exit this form and proceed to complete and submit the "Request Extension of Time to Request a Screening Review" form. The Screening Officer will review your reason(s) and determine whether to grant an extension. The maximum extension is an additional 15 days for a total of up to no more than 30 days from the Date of Issue stated on the Penalty Notice/ticket.

This Request for a Screening Review must be submitted within 15 days of the Date of Issue. Requests received on the 16th day or later, will not be considered and the following provisions apply:

You shall be deemed to have waived the right to request a Screening Review or Request Extension of Time to Request a Screening Review;
You shall be deemed to agree with and to accept the Penalty Notice;
The Penalty Notice shall not be subject to any further review, including a review by any court.

Please be sure that all information, including your contact information, is accurate and complete.

Penalty Notice Recipient Information

Last Name or Single Name

First Name

Primary Phone Number

Email Address

Street Number

Street Name

Apt/Lvl/Unit (if applicable)

Forms

Request for a Screening Review