ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar No., and Address):
TELEPHONE NUMBER: FAX NUMBER:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
CITY AND ZIP CODE:
PHONE NUMBER:
BRANCH NAME:
191 North First Street
San José, California 95113
(408) 882-2100
Downtown Courthouse, Civil Division
PLAINTIFF (Processing Agency):
DEFENDANT (Appellant):
FOR COURT USE ONLY
NOTICE OF PARKING/ADMINISTRATIVE APPEAL
CASE NUMBER:
This is a Notice of Appeal of the decision of the hearing officer in the matter of parking
citation number .
This appeal is filed pursuant to California Vehicle Code (CVC) § 40230.
Appellant attaches a copy of the hearing officer’s decision and requests that:
1. The Clerk of the Court set the matter for hearing before the above-entitled court, where it
will be heard in accordance with CVC § 40230 and CVC § 40215.
2. The Clerk of the Court gives notice of the time and place of the trial to each of the parties.
Appellant certifies that a copy of this Notice of Parking/Administrative Appeal has been mailed
to the Processing Agency at the address shown below:
Date:
CV-5041 8
/01/05
NOTICE OF PARKING/ADMINISTRATIVE APPEAL Page 1 of 1
(TYPE OR PRINT NAME) (SIGNATURE OF APPELLANT)
ATTACHMENT CV-5041
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