Administrative Citation Appeal – Request For Hearing

Completely fill out all required information prior to submitting. The City Attorney’s office will contact you once a hearing date has been set. 

Submissions received later than 30 days after the date of the citation notification letter will not be accepted pursuant to Roseville Municipal Code § 2.50.060.

*Citation Number:
*Home Address:
Mailing Address (if different from above):
*Phone Number:
*Reason for Appeal:
By checking this box, I certify that I am the individual named on the citation and am appealing the administrative citation issued to me.
 I certify under penalty of perjury that the information above is true and correct to the best of my knowledge.


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