Fillable Request Review Citation

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Request Review Citation

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The Request Review Citation form is 1 page long and contains:

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  • 15 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Village of Lincolnshire

BROWSE VILLAGE OF LINCOLNSHIRE (IL) FORMS

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1 Olde Half Day Road, Lincolnshire, IL 60069
www.lincolnshireil.gov
P: 847-913-2350
F: 847-883-9909
Page 1 of 1
REQUEST TO REVIEW CITATION
Before due date, complete and
submit with a copy of the citation
CITATION INFORMATION
Ticket #
Date of Violation
Location of Violation
Vehicle License #
State
Nature of Violation
REQUESTOR INFORMATION
Name
Driver’s License #
State
Address
City/State/Zip
Telephone #
Email Address
JUSTIFICATION TO REVIEW THE CITATION
Please explain why citation should be reviewed and attach any supporting documentation.
Signature
Date
LINCOLNSHIRE POLICE USE ONLY
OFFICER THAT ISSUED CITATION
Name/Badge #
Recommended Action:
Void Ticket
Uphold Ticket
Convert to Warning
Signature
Date
SUPERVISOR REVIEWING CITATION
Chief of Police or Designee
Authorized Action:
Void Ticket
Uphold Ticket
Convert to Warning
Signature
Date
NOTIFICATION OF DISPOSITION MADE
Signature
Date
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Request Review Citation

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Completed 13 July 2020

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