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2. Administrative Appeal Hearing Form
   This form is to be used to appeal an administrative citation that has been received. A hearing for your citation will only be scheduled after the city has received full payment of your citations. If the Hearing Officer decides to lower or cancel the citation, you will be issued a refund. If you have any questions regarding the appeal process, please visit the City Clerk’s office during regular business hours or call 831-899-6707.
4. Appelant Information
6. Citation Number*
8. Name of Appellant*
10. Resident at*
12. Phone Number*
14. Alternate Phone Number
16. Reason for Appeal
    Give a brief statement of why you are appealing and why the notice of violation/administrative citation should be revoked, modified or otherwise set aside.
18. Statement of Reason for Appeal*
20. Do you have any additional sheets, documents, or photos you wish to submit in support of your appeal?
22. Signed*
23. Date*
    Date
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field